Archive for Advocacy

Medical Association of Alabama Advancing Prior Authorization Reforms – Launches Website ALFixPriorAuth.com

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Medical Association of Alabama Advancing Prior Authorization Reforms – Launches Website ALFixPriorAuth.com

Prior authorization (PA) processes have become a significant challenge for physicians, leading to delays in necessary treatments and increased administrative burdens which negatively affect patient care. Recognizing these challenges, the Medical Association of Alabama is committed to supporting comprehensive and meaningful PA reforms, both in Alabama and Washington, D.C., which build on the success seen in other states as well as with some federally-regulated plans.

For context, 35 states have established laws regarding response times for PA requests, with 11 states mandating a 24-hour response for urgent care and 15 states requiring 48 hours. Additionally, for non-urgent care, 11 states require a 48-hour response and 10 states require responses in less than 72 hours.

Regarding patients with chronic conditions and prior approval for a medicine or treatment, Medicare Advantage plans now must maintain coverage for the entire course of treatment once one is approved. As well, 90-day grace periods for patients switching health plans or products have also begun being implemented in various states. In neighboring Tennessee for example, in 2025 carriers must begin honoring an existing PA for the first three months of an enrollee’s coverage under a new health benefit plan.  Similar requirements are in place in other states as well and Medicare Advantage now requires (effective January 2024) a 90-day grace period for patients changing plans.

As hard as PAs are on patients and their physicians, once approved, they should be honored to prevent disruptions in treatment plans and additional administrative burdens. Medicare Advantage plans as of January 2024 cannot retroactively deny coverage and currently, 24 states, including Louisiana, North Carolina, and Tennessee, mostly prohibit retroactive denials once approved except in extreme instances.

Actual review of a physician’s submitted PA is another area of contention where significant progress can be made.  The sooner a physician licensed in the same state in the same or similar specialty with experience treating the condition in question is involved in the PA, the better for patients. But why wait until an adverse determination is made? If a physician requests a peer-to-peer review for his or her patient’s needs, the physician should timely receive one. Utilization of non-physicians and even artificial intelligence to vet medical necessity are areas of significant concern the Association believes needs significant safeguards to protect patients against inappropriate denials of care and ensure that clinical decisions are made by qualified physicians who fully understand the complexities of patient care.

Transparency in understanding what is required by payers for PA processes is also essential. Things like the clinical criteria and other standards utilized in review, not to mention a list of the medical services and drugs requiring prior authorization, should be clearly posted on payers’ websites.  Best practices and current trends dictate what new criteria or requirements regarding PAs should be announced at least 90 days before implementation in order for practice workflows to be adjusted to meet patients’ needs. Currently, 24 states require 90 days’ notice of new requirements, including Georgia, Tennessee, and Louisiana. Additionally, multiple states prohibit inquiries for unrelated medical information from being included in PA processes.

Annual public reporting of PA denials is becoming widely available, specifically related to the percentage of approvals versus denials for all codes or groups of codes requiring prior authorization. Currently, 19 states require public reporting, including Georgia, Louisiana, and Tennessee, with nine requiring posting to insurers’ websites and 10 requiring reporting to a state agency or public official.  A few states go so far as to require an agency or public official to issue a report to the public or state legislature. Furthermore, Medicare Advantage, Medicare, Medicaid, Medicaid MCOs and many QHPs will soon be required to report PA metrics on their websites under the CMS interoperability/PA rule.

As PA processes progress toward all-electronic methodologies, varying standards are being implemented.  The “gold standard” for drug electronic PAs – the NCPDP – has been adopted in 14 states, including Georgia and Tennessee.

Speaking of the “gold standard”, developing programs that reduce the frequency of prior authorization requirements for providers with high approval rates – known as gold-carding – would highly improve patient satisfaction, practice workflow and could help reduce health plan administration costs. Best practices and current trends indicate programs are granting “gold card” status for 12 months with semi-annual redeterminations. Currently, 21 states, including Georgia, Tennessee, and Louisiana, have implemented some type of gold-carding or similar programs, with varying eligibility requirements.

The Medical Association is committed to seeing PA reforms like the aforementioned ones implemented in both Washington, D.C., and here in Alabama.  The Association is currently working collaboratively with multiple large payers in Alabama to implement these changes for patients and their physicians. 

What can physicians do?

Physicians can play a crucial role in advancing our efforts by visiting the Association’s Prior Authorization Reform website at ALFixPriorAuth.com. Here, you can learn more about the campaign and share your experiences. Providing a testimonial about how prior authorizations impact your ability to practice medicine and delay patient care will significantly strengthen our advocacy. Your voice is vital in driving change.

We invite you to share your story on how prior authorizations affect your practice and delay patient care. Your testimonial will help us illustrate the administrative burdens and patient care delays caused by current prior authorization processes, reinforcing the urgent need for reform.

Please visit ALFixPriorAuth.com to submit your testimonial. Your participation is essential in our efforts to advocate for a more efficient and patient-centered healthcare system.

Evans Brown, Manager of Government Relations & Public Affairs at the Medical Association of the State of Alabama.

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Posted in: Advocacy, Blue Cross Blue Shield of Alabama, Health, Insurance, Medicaid, Medicare, Prior Authorization

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Prior Authorization Delays ‘Disheartening’ as Patients Suffer and Wait for Care, Says Alabama Doctor

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Prior Authorization Delays ‘Disheartening’ as Patients Suffer and Wait for Care, Says Alabama Doctor

Dr. Amanda Williams, President of the Medical Association of the State of Alabama, recently spoke out on Alabama Public Television’s Capitol Journal about a new campaign to reduce delays in patient care caused by prior authorizations.

Delays caused by prior authorization are a growing problem that leave frustrated patients stuck waiting for medical care their doctors say they need.

“You have a patient who has just come in and they’re excited to feel better. They’re finally getting the treatment that they need or the diagnostic test that they need and then they’re hit with more delays,” Dr. Williams said of prior authorization requirements. “From a patient’s perspective, it can be very disheartening.”

Prior authorizations were once reserved for high-cost treatments, but today, even routine care can be delayed or denied because of these insurance requirements.

According to Dr. Williams, prior authorization is more than just a nuisance; it can significantly impact a patient’s health and well-being.

“The problem is it has now morphed into requiring paperwork for very routine medications, routine imaging, routine care and it causes significant delays in treatment,” said Dr. Williams. “Usually it can take days to get a response and often it will just be a denial and require an appeal and then take even longer. So it can really slow up treatment.”

Physicians are feeling the strain of prior authorization as well, with entire teams now dedicated solely to navigating the red tape.

“We have entire staff that their whole job is doing prior authorizations,” Dr. Williams said. Prior authorizations also result in fewer patients being seen by physicians. A survey of Alabama doctors found that 76 percent said the time they spend on prior authorizations means they see fewer patients in a day. One-third of doctors said they and their staff spend nearly an entire workday each week filling out prior authorization paperwork, following up with phone calls and fighting denials.

In response, the Medical Association and a coalition of health care partners has launched a new online platform—www.ALFixPriorAuth.com—where Alabamians can share their stories of prior authorization roadblocks. The website and the initiative behind it aim to encourage faster insurance approvals for needed medical care.

Physicians are calling for important reforms, including eliminating repeat authorizations for chronic conditions and quicker responses from insurers. The stories submitted through the website will be crucial in driving these changes.

Watch Dr. Williams’s full interview on Capitol Journal here.

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Congress Considers Expanding Medicare Coverage for Prescription Weight Loss Medications

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Congress Considers Expanding Medicare Coverage for Prescription Weight Loss Medications

By: Jessie Bekker, Burr & Forman LLP

Some Congressional leaders voted to expand Medicare coverage for prescription medications to treat obesity.

The House of Representatives Ways and Means Committee voted in late June to pass the Treat and Reduce Obesity Act of 2023. If passed, the bill would approve Medicare Part D coverage for glucagon-like peptide-1 agonists, or GLP-1 agonists, including semaglutide, a diabetes medication. 

The medications, also approved by the Food and Drug Administration (FDA) for the treatment of cardiovascular disease, have gained popularity under name brands including Wegovy and Ozempic for their promotion of weight loss. 

The Treat and Reduce Obesity Act of 2023 would allow Medicare Part D to cover obesity treatment medications for those who also present with at least one comorbidity. The Act would also expand Medicare coverage for intensive behavioral therapy related to obesity when provided upon referral from primary care providers by other physician specialists and health care providers, including nurse practitioners, physician assistants, registered dietitians and clinical psychologists. (Medicare currently only provides coverage for obesity-related intensive behavioral therapy provided by primary care practitioners).

A version of the bill was introduced in the Senate in 2023 and referred to the Committee on Finance.

The bill has received bipartisan support, but it is not the first time Congress has considered the measure. In 2021, Congress considered a bill by the same name in both the House and Senate, but it gained little traction.

According to the Congressional Budget Office (CBO), which assesses the estimated economic impact of proposed legislation, “the evidence suggests that the amount of potential savings on cardiac care and other health care would be less than the current net federal cost of [anti-obesity medication],” basing its determination on the current costs of those medications against spending on treatment of common conditions associated with obesity, like cardiovascular disease. The CBO attributed the net economic loss to the high cost of anti-obesity medications and comparatively small decrease in health care spending by people who lost weight and experienced health benefits. The CBO further noted that it expected Medicare cost-sharing and premiums to increase in the event of coverage for anti-obesity medications.

Concurrently, Medicare Advantage providers are contemplating coverage for anti-obesity medications. In statements to Modern Healthcare, Kaiser Permanente’s Kaiser Health Plan and CVS Health’s Aetna reported that each would begin providing coverage for brand name Wegovy to their enrollees.

The CBO reported that U.S. net sales of Ozempic, Wegovy, and Rybelsus, an oral version of Ozempic versus its injectable counterpart, totaled $3.4 billion in the second quarter of 2023, while U.S. net sales of all glucagon-like peptide-1 agonists in that time period totaled $5.9 billion. Meanwhile, FDA reports show demand for semaglutide injections have driven shortages of the drugs.

Jessie Bekker is an attorney at Burr & Forman LLP practicing exclusively in the firm’s healthcare practice group. Jessie can be reached at jbekker@burr.com or (205) 458-5275.

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Discussions with Decision Makers: Rep. AJ McCampbell

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Discussions with Decision Makers: Rep. AJ McCampbell

What first prompted you to consider running for office?

I was a investigator with the D.A. office and a legislator was trying to move a high school to an area that was going to benefit a big business person that did nothing but bring the school down because the land was only suitable for industrial development. I decided to run against him and it was that that made me decide to represent people in my area.

How will your background help serve you in the Legislature?

I have been a grocery clerk so I’ve worked shift work in the grocery industry. I’ve been a police officer and investigator w/ the D.A. office and also owned some restaurants and night clubs and have also been in the insurance business. That background has given me insight into the gambit of needs in our state and allows me to see not just to see the employer point of view, but also understand how to help the employees. I am able to look at the big picture and their are a lot of strokes that go in to that picture and if we take some of those strokes out then that affects us and the big picture.

What are some of your legislative priorities for next session?

To try and get some truth and advertising in the insurance warranty industry. Insurance companies have language that they are not liable to fully replace. Furthermore, I want to make where judges, sheriff’s and DA’s don’t have to run on a party ticket.

What are some health-related issues important to your district and your constituents

The health industry is important. We have the highest bad healthcare outcomes and its usually because we don’t have people seeing physicians. When doctors leave and go to urban areas they stay there.  We are excited about the Demopolis school to cultivate interest in healthcare and hopefully they can go back to the where they were raised which could be rural areas. We now have people being trained in rural areas that will truly train people who will be staying in Alabama.

What do you think people understand the least about our health care system?

Health outcomes are based on early intervention, early diagnosis and continuous monitoring. I don’t think people understand how important is to go see your doctor on a regular basis. I think the misunderstanding is that physicians do make a good living, but they are like teachers in not getting paid for their true value.

If you could change anything about our state’s health care system, what would it be?

Reimbursement rates and the ability of the practitioners to be the drivers of the care that their patients receive. Have we been smart enough as of state to not politicize Medicaid expansion, then billions of dollars that would have been generated for the number of people covered. We have lost untold billions of dollars because we didn’t expand Medicaid expansion and we politized it and said we didn’t want the money and Obama being the face of it was politized for the wrong reasons.  Healthcare should never be a political issue.

How can the Medical Association – and physicians statewide – help you address Alabama’s health challenges?

Be more vocal within the political arena about the challenges that they are actually facing. The health care industry has to get the average joe on the same side and start advocating for things that will help the average joe which will help carry the message for the things needed in healthcare.

What is the one thing you would like to say to physicians in your district?

Hang in there, the reinforcements are on their way.

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Medical Association Endorses Prior Authorization Bill Reintroduced in Congress

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Medical Association Endorses Prior Authorization Bill Reintroduced in Congress

On June 12, bipartisan lawmakers introduced an updated version of the Improving Seniors’ Timely Access to Care Act in both the House (H.R. 8702) and Senate (S. 4532). The Medical Association is supporting the latest version of this legislation that was introduced, once again, by Senators Roger Marshall, MD (R-KS), Krysten Sinema (I-AZ), John Thune (R-SD), and Sherrod Brown (D-OH), as well as Representatives Mike Kelly (R-PA), Suzan DelBene (D-WA), Ami Bera, MD (D-CA) and Larry Bucshon, MD (R-IN). 

In the 117th Congress (2021-2022), the Improving Seniors’ Timely Access to Care Act garnered more than 378 total bipartisan cosponsors in the House and Senate and also passed the full House of Representatives. In addition, the legislation secured endorsements from more than 500 outside organizations, including the Medical Association of the State of Alabama and numerous other national and state medical societies.  

Unfortunately, the version of this bill that passed the House in the 117th Congress was never considered in the Senate because it produced a score of $16 billion from the Congressional Budget Office (CBO), thus necessitating modifications to lessen the bill’s fiscal imprint. While electronic prior authorization rules that the Biden administration finalized in Jan. 2024 lowered the $16 billion score substantially, the recently introduced bill is amended to ensure it ultimately scores as close to $0 as possible.  

More specifically, the legislation requires the Office of National Coordinator for Health Information Technology (ONCHIT) and the Centers for Medicare & Medicaid Services (CMS) to submit a report to Congress on the use of prior authorization in Medicare Advantage and what constitutes “real-time decisions” for “routinely approved services.” The legislation also delegates explicit authority to CMS to implement this newly defined real-time prior authorization decision-making process for routinely approved services in Medicare Advantage. Finally, the legislation delegates explicit authority to the secretary of Health and Human Services to enforce the real-time prior authorization processes for routinely approved services and issue tighter timelines for health plans to make utilization management decisions, such as 24 hours for emergent services.  

Of note, the legislation is unchanged as it relates to: 

·         Mandating compliance with uniform electronic prior authorization technical standards 

·         Barring Medicare Advantage plans from utilizing faxes or proprietary payer portals 

·         Including robust transparency requirements (e.g., disclosure of policies and evidence utilized in formulating prior authorization, listing of all services subjected to prior authorization, how many services are denied and overturned on appeal, etc.) 

·         Permitting insurers to create gold-carding programs 

Click here for the Endorsement List.

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Here’s How Alabamians Can Fight Insurance Red Tape That Delays Medical Care

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Here’s How Alabamians Can Fight Insurance Red Tape That Delays Medical Care

Alabama doctors and patients frustrated with delays in care caused by insurance companies’ prior authorization process now have a new way to share their stories and promote change.

A new online platform — www.ALFixPriorAuth.com — invites Alabamians to share their experiences with prior authorization problems. The website and the initiative behind it to encourage faster insurance approvals for medical care was started by doctors with the Medical Association of the State of Alabama.

Doctors say delays caused by prior authorizations can have dangerous impacts on their patients’ health.

>>>Watch this video: Doctors Discuss the Burdens of Prior Authorization<<<

“With prior authorizations, we definitely see a delay in patient care,” said Dr. Tonya Bradley, a physician in Auburn. “I see delays in patients getting chemo, I see delays in patients getting tests they need to diagnose problems that can be very urgent.”

What is Prior Authorization?
Before your doctor provides a treatment, your insurance requires them to prove you need it. Decades ago, prior authorization was used sparingly and typically only to make sure some expensive treatments were absolutely necessary.

But today, even routine medical care requires insurance approval. Denials mean patients and doctors must spend time fighting insurance companies for care.

Takes Time Away From ‘What Really Matters’
When doctors have to spend time arguing with insurance companies over prior authorizations, it means there’s less time for doctors to spend with their patients – their number one priority.

“The bureaucracy. The paperwork. The institutional inertia. The list goes on and on, and it makes it very difficult for us to do what really matters, which is take great care of our patients,” said Dr. George Koulianos of Mobile.

What Alabamians Think
A survey of Alabama doctors found that 76 percent said the time they spend on prior authorizations means they see fewer patients in a day. One-third of doctors said they and their staff spend nearly an entire workday each week filling out prior authorization paperwork, following up with phone calls and fighting denials.

A separate survey of 500 Alabamians showed that 80 percent agree with the statement that “doctors in Alabama are working to spend more time with patients, so that patients and doctors have the time together to make the best health care decisions.”

Dr. Hernando Carter said being able to spend more time with patients rather than prior authorizations results in better health care.

“If you can spend the time to explain to your patient why you’re recommending a test or why you’re recommending a treatment and be able to answer all the questions they have and assuage any concerns or apprehensions they have, then that directly affects how well they do. It directly affects whether they get better or not,” the Birmingham physician said. “So, we abhor anything that interferes or cuts into that time that we have to do that with our patients.”

“We need to have the ability to take care of our patients in an efficient manner, expedite the care and not go through all the red tape,” said Dr. William Admire of Mobile. “When we slow down the progress of patients’ recovery, no one wins.”

Steps to Fix Prior Authorization
Physicians with the Medical Association have begun conversations with the health insurance community to push for changes. Stories submitted through www.ALFixPriorAuth.com will help support efforts to fix prior authorization in Alabama.

Among the changes doctors want to see are an end to repeat prior authorizations for patients with chronic conditions and faster response times from insurers.

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Medical Association Unveils ‘Your Care is at Our Core,’ Emphasizing Personal Connection in Health Care

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Medical Association Unveils ‘Your Care is at Our Core,’ Emphasizing Personal Connection in Health Care

83% of Alabamians Agree: Doctor-Patient Relationship is ‘Central’ to Health

A strong bond between doctors and patients leads to better health care, say Alabama doctors. A new awareness campaign launched by the Medical Association of the State of Alabama called “Your Care is at Our Core” reinforces this important message.

A doctor-patient relationship based on mutual trust allows doctors to help patients navigate what can be complex health challenges. It is a responsibility doctors say they don’t take lightly.

“From the moment that you begin training to become a doctor, it’s made very clear and apparent to you that people are going to place their trust in you. They’re placing their lives in your hands so you have to take that very seriously,” said Dr. Hernando Carter, a doctor of internal medicine in Birmingham. “It has to be the most important thing to you.”

Building Trust
Trust is essential because patients are more inclined to share crucial information about their health concerns and personal circumstances when they feel a genuine connection with their doctor.

This honest exchange of information enables doctors to make informed decisions, tailor treatment plans and provide care that aligns with each patient’s unique needs and preferences.

A Collaborative Approach to Wellness
Moreover, a strong doctor-patient relationship fosters a supportive environment where patients feel empowered and engaged in their healthcare journey. When patients feel heard and valued, they are more likely to adhere to treatment regimens, follow medical advice and actively participate in the shared decision-making process.

“I tell my patients all the time that I can’t make you well on my own. It’s a team effort, something that we have to work together on and I think that resonates well with patients,” said Dr. Brittney Anderson, a family physician in Demopolis.

‘Be a Good Listener’

Physicians recognize that effective communication and empathy are vital in fostering positive patient outcomes. By building rapport and understanding their patients’ concerns, doctors deliver patient-centered care and uphold the sanctity of the doctor-patient relationship as a cornerstone of healthcare excellence.

“One of the most important things when I train medical students and residents is I teach them to sit down with the patient,” said Dr. William Admire, a doctor of internal medicine in Mobile. “The most important thing about being a doctor is to be a good listener, show respect, show empathy, compassion.”

Statewide Consensus
According to a statewide survey conducted in March on behalf of the Medical Association, 83 percent of Alabamians agree “the doctor-patient relationship is central to health care.” The poll also showed that 83 percent agree with the statement: “It is crucial for physicians to be involved in my care so that I have the best outcomes.”

To watch a video of Alabama physicians discussing why they view the doctor-patient
relationship as sacred, click here.

To view the “Your Care is at Our Core” video message, click here.

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2024 Advocacy Agenda

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As the professional association for some 7,000 physicians of all specialties in Alabama, the Medical Association of the State of Alabama exists to serve, lead, and unite physicians in promoting the highest quality of healthcare for the people of Alabama through advocacy, information, and education.

General Policies Supported

The Medical Association supports the physician-led health team model and maintaining the highest standards for medical care delivery across all specialties of medicine.  The Association  supports prohibiting deceptive healthcare advertising and requiring health professionals identify their license to patients.

The Association supports physician autonomy in patient care and medical practice decisions, fair reimbursement for services and reducing the volume of administrative tasks required by insurers which increase annual health spending and negatively impact patient health.     

Further, the Association supports increasing health insurance options for Alabamians, including expanding Medicaid.  The Association supports increasing access to quality mental health care and continued state funding for the Maternal Mortality Review Committee and the Infant Mortality Review Committee.  Recognizing the long-term effects of social determinants of health on individuals, families and ultimately communities, the Association supports comprehensive solutions to addressing these challenges, with emphasis on pipeline programs, tax credits and loan forgiveness proposals benefitting rural and underserved areas.

Finally, by ensuring medical liability environment stability and pursuing further civil justice reforms, the Association believes Alabama can continue to attract highly-qualified physicians.

Specific Policies Supported

For 2024, the Association specifically supports:

  • Streamlining the prior authorization process for physicians and patients
  • Initiatives to grow and support Alabama’s physician workforce
  • Increasing access to physician-led care in rural and underserved communities
  • The ability of medical practices to set patient practice policies
  • Increasing physician representation on state healthcare boards, task forces and committees

General Policies Opposed

The Medical Association opposes any scope of practice expansion for non-physicians that would fracture the physician-led health team model, lower quality of care and/or increase costs.  The Association also opposes any interference with the physician-patient relationship and attempts to reduce a physician’s autonomy in patient care or medical practice decisions.

The Association opposes legislation or other initiatives that could increase lawsuit opportunities against physicians, including the establishment of statutory standards of care or any statutory dictums for medical care delivery.  The Association also opposes any state-level increase of requirements for Maintenance of Certification.  Finally, the Medical Association opposes tax increases disproportionately affecting physicians.

Specific Policies Opposed

For 2024, the Association specifically opposes:

  • New lawsuit opportunities against physician employers and medical practices over employment policies
  • Efforts to reduce and/or politicize physician involvement in health regulatory affairs
  • Expanding Prescription Drug Monitoring Program (PDMP) access for law enforcement
  • Statutory requirements for mandatory Prescription Drug Monitoring Program (PDMP) checks



Download PDF of Agenda
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Association Kicks Off 11 Regional Receptions Tour Across Alabama

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Association Kicks Off 11 Regional Receptions Tour Across Alabama

This Fall, the Medical Association’s Governmental Relations team kicked off its Regional Receptions Tour across the state to bring lawmakers and physicians together to help discuss issues affecting medicine in Alabama.  Partnering with 9 medical specialty societies to put on these events, the Association is working to host 11 receptions reaching from Mobile to the Shoals area of Alabama and many places in between. 

At each of these receptions, the Association and other partnering specialties present information to lawmakers to educate them on a variety of topics of interest to physicians and patients.  Local physician involvement is vital to the Medical Association’s success for its members and the patients under their care.  These receptions serve as an excellent opportunity for physicians and local lawmakers to interact and discuss the challenges medicine faces in maintaining access to quality care for patients.

These 11 receptions offer a first-rate occasion for a supportive, multi-specialty effort to proactively educate lawmakers on issues of interest to medicine and foster strong working relationships between local physicians and their elected officials. While the Association and its Government Relations team serve as the “boots on the ground” when working with legislators on health care policy in Alabama, there is no more impactful outreach to legislators on health care issues than that of a local physician constituent. 

The Medical Association appreciates its specialty society partners and the physicians participating in these events.  The Association looks forward to updating its physician members at the conclusion of the 11-reception tour.

Thank you to the specialty societies partnering with the Association on these events:

Alabama State Society of Anesthesiologists

Alabama Academy of Family Physicians

Alabama Section – American College of Obstetricians and Gynecologists

Alabama Academy of Eye Physicians and Eye Surgeons

Alabama Orthopaedic Society

Alabama Psychiatric Physicians Association

Alabama Academy of Radiology

Alabama Chapter – American College of Emergency Physicians

Alabama Society of Allergy, Asthma & Immunology

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Discussions with Decision Makers: Senator Robert Stewart

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Discussions with Decisionmakers

Senator Robert Stewart, a native of Selma, is the newly elected Senator of District 23 and received a bachelor’s degree in Accounting from Tuskegee University and a Masters in Accounting from Kennesaw State University. Stewart is a former aide to U.S. Rep Terri Sewell, and he worked in an advocacy role at Public Citizen Inc., a Washington D.C.-based nonprofit. He is a graduate of the Congressional Black Caucus Institute Boot Camp and was elected to the inaugural Youth Caucus of the newly reformed Alabama Democratic Party State Executive Committee.

What first prompted you to consider running for office?

Gratitude. I had a great childhood and was reared in the district. District 23 shows great promise. I view the region as the “epicenter of southern hospitality.” It is an honor of a lifetime to represent the interests of such amazing people and communities.

How does your background help serve you in the Legislature?

I am an accountant by trade, former congressional staffer with a strong understanding of government, and with a record of service/community involvement that has equipped me with the skills necessary to serve.

What are some of your legislative priorities next term?

Priorities for me is passing legislation that improve the quality of life for the district with focuses on putting people first, economic development, healthcare, education, and infrastructure.

What are some health-related issues important to your district and your constituents?

Most of the counties in my district don’t even have access to a pediatrician. We must do introspection on what that means for communities. Children are the lifeline of any community and in many cases, without a pediatrician it is difficult to keep them healthy. Access to healthcare is a huge hurdle, there are counties in my district that don’t even have a hospital. Addressing the social determinants of health in the district is critical.

What do you think people understand the least about our health care system?

Too many have been propagandized so much that they do not understand that they deserve more. It is difficult for many people to see their way of hardship because of how expensive healthcare is. In other countries, there is Medicare for all, and citizens aren’t bankrupted by their healthcare system.

If you could change anything about our state’s health care system, what would it be?

Medicaid expansion would be a top priority; Hospitals are at the very minimum an acute health system in every county of the state.

How can the Medical Association – and physicians statewide – help you address Alabama’s health
challenges?

The Medical Association can continue its advocacy to ensure that health outcomes are improved statewide.

Do you have a position on the expansion of Medicaid?

I fully support Medicaid expansion.

What is the one thing you would like to say to physicians in your district?

Thank you for going above and beyond keeping out communities healthy.

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