Democrats propose Medicaid expansion

JUNEAU (AP) — House and Senate Democrats on Thursday proposed legislation that would expand Medicaid coverage in Alaska after Gov. Sean Parnell last year refused calls to do so.

The proposal would extend eligibility to those up to 138 percent of the federal poverty line. State participation would be contingent upon the federal government paying at least 90 percent of costs, the lowest level to which they are currently expected to fall.

The proposal was introduced in the House as HB290. Companion legislation is expected to be introduced in the Senate on Friday.

Sen. Bill Wielechowski, D-Anchorage, said expanded coverage makes sense morally and financially. He called the proposal “commonsense, no-brainer” legislation that he hopes will attract Republican support.

Democrats said the proposal would extend coverage to about 40,000 Alaskans.

The U.S. Supreme Court, in upholding most of the federal health care law in 2012, also held that states cannot lose existing Medicaid funding if they don’t expand Medicaid coverage levels. In states that have opted for expansion, the federal government is expected to cover the cost for the first three years, through 2016, and the bulk of the cost indefinitely, with the states contributing.

Parnell last year faced pressure from health, advocacy and business organizations to expand coverage. He cited financial concerns in his decision, saying a “costly Medicaid expansion, especially on top of the broken ‘Obamacare’ system, is a hot mess.”

Medicaid is a major driver of the state’s budget, and there are concerns with health care costs and access in Alaska. Parnell proposed creating an advisory group to make recommendations to reform Alaska’s Medicaid system. He also asked health commissioner Bill Streur for a report describing the safety net for non-Medicaid-eligible Alaskans.

Parnell spokeswoman Sharon Leighow said by email that Parnell’s position hasn’t changed. She said he looks forward to Streur’s report, expected in February.

Members of the House Republican-led majority responded coolly to the Democrats’ proposal.

Rep. Mia Costello, R-Anchorage, questioned whether this was a long-term solution or if there is a better way to address Alaskans’ concerns.

“Show me a program that the federal government has provided money for that they haven’t either decreased or taken away from us,” Costello said at the majority’s weekly news conference. “It’s hard to find.”

House Majority Leader Lance Pruitt asked a reporter how he would like having a microphone taken from him halfway through a question. He said if the Legislature is going to have a discussion on Medicaid expansion, it needs to ask whether the state would be willing to take over the program “when the feds do ultimately take it away from us.”

“Because just like you don’t want that microphone or maybe it’s like a child and you give them something, you give them a toy, you’re not going to yank it out of their hands. And that’s essentially what this is. We’re trying to look out for the best thing for Alaskans.”

The state Democratic party chairman later called on Pruitt to apologize and “stop demeaning” Alaskans who would benefit from Medicaid expansion.

“If Pruitt thinks health care is no more necessary than a toy, then he is completely out of touch with the economic realities facing Alaskans who are seeking affordable health coverage,” Mike Wenstrup said in a release.

Pruitt said in an interview that this is a serious issue that several members spoke to. He didn’t think Wenstrup’s release portrayed their position, that it’s a “budget-busting unfunded mandate for us.”

Sen. Berta Gardner, D-Anchorage, said a constituent who did not qualify for Medicaid or subsidies to buy private insurance on online marketplace “begged us to do something about the Medicaid expansion because that would cover him.”

She said even if the feds did not hold to their promised level of funding and the program lasted only a few years, it would allow a “tremendous number of Alaskans” to address health care needs they couldn’t take care of before.

The value of coverage, even for a short period, “can be immense to individuals and families,” Gardner said.




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