Gov. Bentley’s decision not to run Alabama’s own health care exchange and expand Medicaid is no surprise.

I do not fully support the health care law and feel revisions are needed. I do support the pre-existing conditions, allowing more children to stay on parents insurance, and limits on insurance companies collections of premiums and loss ratio. However, I feel the decision to opt out needs to be more fully explained to Alabamians.

From 2014-17 the federal government is responsible for payment of Medicaid coverage 100 percent. After 2017 the federal government pays at least 90 percent of the Medicaid cost. I can only assume the $50 million cost is 10 percent of the total cost beginning in 2018 to insure 228,000 people.

Those who have insurance pay a hidden tax in the form of higher insurance payments to offset the cost for treatment of uninsured patients. I would assume more people with insurance could lower rates.

The ratio of Medicaid payments to insurance payments in Alabama is 63 percent which is higher than many states. Does the governor include any changes in this rate within his $50 million price tag?

Opting out does not prevent the citizens of Alabama from obtaining insurance through a federal program. Does the governor feel it is better for the federal or state government to make the decision?

If I understand everything correctly, the $50 million would be the cost in 2018. So does Bentley believe the economy in 2018 will be the same as it is in 2012? What is he doing to improve the economic condition of the state?

As New Jersey Republican Gov. Chris Christie says, “... if you do your job, the voters will give you their votes. If you don’t, they won’t.”

Judie Paganelli

Florence