Alabama is one of 14 states that has not expanded Medicaid, which according to a new study will deprive the state of an economic boost of more than $11 billion over four years.

David J. Becker, Ph.D. at the UAB School of Public Health, updated an earlier report to show the economic impact if Alabama lawmakers vote to expand Medicaid. His report also shows 340,000 residents of the state would gain coverage under Medicaid with a state-approved expansion.

Becker said the ripple effect of the influx of federal dollars and increased Medicaid enrollees would create more health care services and employees needed to support the growth. In a nutshell, Alabama would be providing a valuable service to more residents and generate additional tax revenue with the increase in jobs.

The federal government will provide $9 for every $1 the state spends on the expanded enrollment in Medicaid, creating a minimal cost for the state in comparison to the projected growth.

Based on states that have already expanded Medicaid programs, Manatt, a national consulting firm, released a report that backs Becker’s enrollment estimates and adds to it the potential for state savings.

Deborah Bachrach, a partner with Manatt, said Alabama could free up almost $60 million the first year of expansion, with an increasing amount each year, providing more dollars to reinvest in maintaining the state’s health care delivery system.

When Congress passed the Affordable Care Act, the assumption at the time was that states would expand Medicaid to help cover the uninsured. In an effort to offset the costs of expansion, Congress mandated cuts in payments hospitals receive to cover the cost of the uninsured.

Alabama’s hospitals are scheduled to lose $119 million in federal funding, unless Congress takes action, according to Owen Bailey, chairman of the board of the Alabama Hospital Association and CEO of USA Health.

Hospitals across the state currently spend more than $500 million each year in care for which they receive no reimbursement. Bailey said three-fourths of the state’s hospitals are operating in the red, while 12 hospitals have closed over the last 8 years.

Gov. Kay Ivey has shown interest in the expansion, but questions how the state will afford up-front the cost.

The economic and humanitarian values of increasing Medicaid are strong. State House Speaker Mac McCutcheon has told colleagues it is time for leaders to look more at legislation for the long-term and stop patching up problems year to year.

Alabama is enjoying one of its most productive economic cycles with job expansions and low unemployment in most areas. The time appears right for serious consideration of expanding Medicaid. If lawmakers feel confident in the study showing economic growth, this will be the year to step forward in a move that considers the future and the health of thousands of Alabamians.