On Wednesday, U.S. Sen. Doug Jones, D-AL, joined with his Democratic colleague Sen. Mark Warner, D-VA, to introduce the States Achieve Medicaid Expansion (SAME) Act, which would ensure that states that has yet to expand Medicaid, as allowed under the Affordable Care Act (ACA), are eligible to receive the same level of funding as states that approved an expansion earlier.

Alabama is among 14 states that have not expanded Medicaid – the other holdout states are Wyoming, South Dakota, Wisconsin, Kansas, Oklahoma, Texas, Missouri, Tennessee, Mississippi, Georgia, North Carolina, South Carolina and Florida.

“For years, leaders at Alabama’s rural hospitals have been warning public officials about the financial cliff they are facing, in large part as a result of the state’s refusal to expand Medicaid,” a press release from Jones’ office said.

Since 2011, 13 hospitals have closed across Alabama, seven of which were located in rural areas and approximately 88 percent of rural hospitals still operating are doing so at a loss.

According to the Alabama Hospital Association (AHA), approximately 326,000 Alabamians would gain health insurance if the state expanded Medicaid.

“By refusing to expand Medicaid, Alabama has turned away $14 billion of our own taxpayer dollars,” Jones said. “For years, those dollars could have helped keep our hospitals open, support good jobs in our communities and provide health coverage for hundreds of thousands of Alabamians. This isn’t a partisan issue – expanding Medicaid is the right thing to do.”

According to the press release, studies have shown that “expanding Medicaid benefits states economically by increasing jobs and earnings growth, generating federal revenue, increasing Gross State Product, increasing state and local revenues and reducing uncompensated care and hospital costs.”

Further, the state could have collected $935 million in additional tax revenue and created around 12,000 jobs in 2016 alone if it had expanded Medicaid.

“Alabama can no longer afford not to expand and our SAME Act legislation would ensure that states will get a fair deal when they do,” Jones said. “I urge my colleagues on both sides of the aisle, and on both sides of Capitol Hill, to support this common-sense bill.”

In states that have refused to expand Medicaid under the ACA, more than two million low-income adults fall into a “coverage gap” because of incomes too high to be eligible for Medicaid but too low to receive tax credits to purchase healthcare.

“Without Medicaid expansion, most of these individuals are likely to remain uninsured, as they have limited access to employer coverage and frequently find the cost of unsubsidized marketplace coverage to be prohibitively expensive,” the press release said.

The SAME Act would ensure that holdout states receive the same levels of federal funding, which would amount to $2 billion in its first year for Alabama, as those states that expanded Medicaid immediately or shortly after the passage of the ACA.