Alabama is a fairly small Southern state with substantial low-income and minority populations. The Medicaid program is heavily dependent on intergovernmental transfers and provider taxes to fund the state share and funding crises have been routine. By and large, Alabama's Medicaid program relies on minimum federal requirements to determine eligibility and coverage policy. Most of Alabama's social programs are severely constrained because of the relatively limited tax base, the fact that most tax revenues are earmarked for education, and the strong anti-tax sentiment of the state. The low levels of revenue leave policymakers with little choice but to provide health and welfare benefits at fairly minimal levels.
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