MONTGOMERY — If Alabama is ever to expand Medicaid under the federal Affordable Care Act, now is the time to do it, health care economists said Tuesday.

“If you delay for a year or two or three, you give up the biggest federal contribution,” said David Becker, of the University of Alabama at Birmingham. “Delaying the expansion does cause us to miss the boat.”

Becker and Michael Morrisey, who co-authored a study on what adding about 300,000 new enrollees would mean for the state, spoke Tuesday at a public forum organized by Senate Democrats.

During a seven-year period starting in 2014, the state would spend an estimated $771 million on the expansion, Becker said. Meanwhile, the federal government would spend about $11.7 billion.

“We will never be left on the hook, as the law is written, for more than 10 percent (of the health care costs),” Becker said.

The expansion would lead to about $20 billion in direct and indirect spending in the state and nearly $935 million in new tax revenue during seven years, according to the UAB study.

Sen. Tammy Irons, D-Florence, said she isn’t a health care expert.

“But as a business attorney, I do understand economic impact studies, and the UAB study is not something we can turn away from,” Irons said.

Right now that is up to Gov. Robert Bentley, and he has said he won’t expand Medicaid. The U.S. Supreme Court last year gave states the ability to decide if they would expand Medicaid under the Affordable Care Act. Many Republican-led states initially said they would not, but some in recent months have changed their minds, including New Jersey and Florida.

Bentley has said he won’t expand Medicaid in Alabama under its current structure, which he says is broken. This year, Medicaid will eat up $615 million from the state’s general fund, more than any other non-education agency. Several recommendations for overhauling the agency were recently sent to him.

Jim Carnes, of the nonprofit group Alabama Arise, said the expansion would mostly help working Alabamians who can’t afford private insurance, including families of four who earn $32,000 or less per year. It also would benefit about 27,000 low-income military veterans.

Dr. Marsha Raulerson, a pediatrician, said Tuesday that with Medicaid, infant mortality and maternal fatality rates have dropped to the lowest ever in the state. But some are still without insurance.

“If you look at the statistics, the children who die are the ones with the worst health care,” she said.

Mary Sell is the Montgomery bureau chief for the TimesDaily. She can be reached at mary.sell@timesdaily.com.