Across the globe, COVID-19 has put a spotlight on the fault lines of our healthcare systems, leaving many people to slip through these cracks.

Unfortunately, Alabama has long struggled with inadequate healthcare, in part due to lack of insurance. The vast majority of Alabamians with private health insurance receive it through their employer; however, COVID-19 has brought about a staggering wave of job losses, with 264,000 new unemployment claims filed in just the last month. More than ever before, it is time for a new approach. Alabama must join the growing majority of states that have expanded Medicaid.

Today, there are 4,500 cases of COVID-19 with 154 reported deaths in Alabama, and the number steadily rises every day. While testing and treatment options are being quickly mobilized to meet this need, they are only accessible to those who can afford them. The U.S. Census Bureau’s 2018 data reports that 10% of the state population has no health insurance at all. What good are Alabama’s ramped-up screening measures if everyone who tests positive can’t afford care?

Though the entire state is grappling with the healthcare crisis presented by this pandemic, those who will be hit hardest are rural communities and people of color.

Alabama’s rural communities are already in a health crisis of their own. Since 2011, seventeen rural hospitals have closed, contributing to the dangerously low number of hospital beds per person in these areas. Per the Alabama State Health Planning Development Agency (ASPDA), over half of the state’s counties have less than 100 hospital beds. Even as more severe cases fill intensive care units across the nation, 22 counties in Alabama are left vulnerable with no ICU beds—period. Medicaid expansion could provide remaining rural hospitals with the funds to stay open during this crisis.

Black populations have already been disproportionately impacted by COVID-19, making up over half of all fatal cases while comprising only a quarter of the state population. These Alabamians are also more likely to lack insurance. Medicaid expansion is the first step towards narrowing the racial disparity in health outcomes, both during this pandemic and long after it has passed.

COVID-19 has widened the already devastating gaps in care many Alabamians face. The time to act is now. Expanding Medicare will address many of the challenges presented by COVID-19, from access to testing to receiving quality care. Professor David Becker from the University of Alabama at Birmingham estimated that 223,000 Alabamians would be newly insured if Medicaid was expanded, which would go a long way towards ensuring that those infected can receive timely care. Furthermore, the recently enacted Families First Coronavirus Response Act provides 100% federal financing of COVID-19 testing for those covered by Medicaid.

This pandemic has already sparked conversation on this long-awaited reform. Cover Alabama is a coalition of over sixty healthcare and advocacy organizations that are calling for Governor Ivey to expand Medicaid in light of COVID-19. Legislation to expand coverage is currently pending in the state house, most notably HB 447.

Why is there still resistance? Governor Ivey has long cited the cost as a major concern. It is estimated that the state would spend $250 million annually for this program, although 90% of the actual cost would be paid by the federal government. In actuality, studies report that Medicaid expansion would save the state of Alabama between $58.9 and $87.6 million per year from 2020 to 2023. Savings are expected from both replacing state funding of other health programs with Medicaid-matched funds and by having the federal government cover more of the costs for state residents who already qualify for Medicaid. These projected savings leave little merit to cost-related arguments against coverage expansion, and shed a light on political motivations for delaying expansion.

COVID-19 has exposed the cracks in our health infrastructure, but we have a unique opportunity to change the story. Expanding Medicaid will not only provide lasting benefits to our state’s economy, but more importantly will save lives now and give more Alabamians a chance at a healthier life long after this pandemic has ended.

Mugdha Mokashi (@mugdhatweets) is an Alabama native and second-year medical student at Harvard Medical School. Howard P. Forman (@thehowie) is a Professor of Public Health, Management, Economics, and Radiology at Yale University.