A brand-new, out-of-state dark-money group launched an attack on Blue Cross and Blue Shield of Alabama over the past week, and has already invested over $320,000 in negative television advertising alone. 

During some of this weekend’s largest SEC football matchups, including Alabama vs. Oklahoma, the group ran a shock-style message that is now being pushed to Alabama voters more aggressively than any political campaign could afford to spend on television at this point in the 2026 election cycle. 

According to business filings, “Alabama Patients First LLC” was formed in Delaware on December 11. The state is known for its Teflon business privacy laws. LLCs are not required to publicly list their ownership or members, making it an ideal vehicle for dark money to reach its target. 

Since its formation, the group has been busy in Alabama.

Using a “Paid for by Alabama Patients First” disclaimer, the group aired television advertisements, launched a website, and directed SMS marketing campaigns directly to voters, igniting a costly media attack against the state’s leading insurer. 

“They make a killing off telling you ‘No.’ Blue Cross Blue Shield: ‘No.’ That’s Blue Cross “B*******,” the ad says.

A station-by-station breakdown of the Alabama Patients First TV buy across multiple Montgomery-area outlets, including WSFA, WAKA, WCOV-TV, WNCF, and others, totals $226,071. 

The group also spent $102,000 across Birmingham, Huntsville, and Dothan media markets.

The buy spans six weekends, ranging from its first airing on December 14, with a much smaller spend scheduled after January 1, to a wind-down on January 18, 2026. 

By comparison, in the Montgomery media market, the group spent $211,633 in December and just $14,438 in January.

In total, the out-of-state group has spent at least $328,071 on pushing the TV spot to Alabama residents. 

Alabama Patients First’s TV spend isn’t the whole tab, either. The professional fees required to deploy such an operation likely reach into the millions – and the timing is striking.

The attack on Alabama began the same week that Jackson Hospital and Clinic, Inc. initiated a high-visibility litigation campaign against BCBS of Alabama. 

Jackson Hospital and its lender, Atlanta-based Jackson Investment Group, are on the clock for a December 31, 2025 bankruptcy court deadline to secure $100 million in public funding, which would help satisfy a debtor-in-possession (DIP) agreement the two signed earlier this year. 

Yellowhammer News requested information from officials at Jackson Investment Group, Jackson Healthcare, and Jackson Hospital to confirm or deny a connection between the hospital’s lending relationship and the creation of Alabama Patients First. 

At the time of publication, those requests went unanswered.

Blue Cross and Blue Shield of Alabama did respond to the negative ad blitz in a statement on Monday afternoon.

“The ads are an intentional misrepresentation of how we do business,” Sophie Martin, Director of Corporate Communications for BCBS of Alabama, said.

“Based on the timing of the ads, we believe they are nothing more than an improper attempt by Jackson’s investor-lender to improperly influence litigation.”

Grayson Everett is the editor in chief of Yellowhammer News. You can follow him on X @Grayson270.