MONTGOMERY, Ala. (WIAT) — Alabama hospitals are getting just a portion of what they asked for in funding from the American Rescue Plan Act bill state lawmakers approved Thursday.

The legislation allocates $1.06 billion federal COVID relief dollars to the state.

The Alabama Hospital Association asked for $375 million out of that bill. Lawmakers included $100 million for hospitals.

“Again, we’re grateful for the $100 million, we just needed $300 [million], $375 million,” said Alabama Hospital Association President Dr. Don Williamson.

Williamson said low Medicare reimbursement rates coupled with a high rate of uninsured patients has left hospitals in the red. According to a study funded by the AHA, from 2019 to 2022, the state’s hospitals lost $1.5 billion, even when accounting for federal funding.

Williamson said its initial request would have only bought time, not solved a problem.

“Unless something changes, unless we’re able to get Medicaid expanded, unless we’re able to close that coverage gap, we’re going to see fewer hospitals in Alabama over the next 18 months than there are today,” Williamson said.

Williamson said the money will be distributed equitably based on hospital size and services provided during COVID-19. For some, he said, it won’t be enough.

“The result is for some of the hospitals that are having to borrow money to make payroll, that are way behind in paying their medical providers or drug bills to pharmacies, any dollars they get is going to be immediately used to meet some of those financial issues,” Williamson said.

While hospitals will get $100 million, the bulk of the bill goes to broadband and water and sewer projects at $660 million.

Lawmakers said addressing infrastructure needs was a priority.

“If you look at everything, that’s where everybody felt it should be,” House Speaker Nathaniel Ledbetter (R-Rainsville) said. “Everyone was in agreement with that.”

Ledbetter said he expects lawmakers will bring legislation during the regular session to address health care needs unmet by the ARPA bill.

While there has been an emphasis on rural health care, Williamson said hospital closures are a statewide problem. He said if rural hospitals close, those uninsured patients will eventually end up in urban hospitals, making the problem worse.