(SitNews - Ketchikan, Alaska) - A report analyzing Alaska’s health care safety net and identifying where gaps exist for Alaskans who fall between the eligibility lines of Medicaid and subsidized insurance on the Federal Healthcare Marketplace was completed by the Department of Health and Social Services and delivered to Gov. Sean Parnell on Monday, June 9.

The report defines the gap population, provides an overview of the safety net services available in Alaska, gives a brief description of funding that supports these services and describes gaps in services for the identified population.

The report loosely defines the gap population as an individual who:

• Is between the ages of 18-64.
• Does not have health insurance.
• Is not eligible for Medicaid.
• Is not covered under another health care system that provides benefits for members (example: tribal health beneficiaries).
• Does not have dependents.
• Has an income less than $14,859/1 person or $19,660/2 person household.
• Is not disabled.

In their 2013 analysis, the Lewin Group estimated Alaska's gap population at about 20,000 individuals. This estimate was developed using 2010 and 2011 data. An independent 2014 analysis by the Kaiser Family Foundation estimated the number as closer to 17,290. For purposes of a starting point, the Alaska Department of Health & Socail Services' analysis used the Kaiser’s estimate of Alaska’s total uninsured population below 100% of the Federal Poverty Level (FPL} at 17,290. Of these 17,290 individuals, the analysis estimated approximately 10,000-12,000 Alaskans met the definition and do not have access to any type of health care coverage.

According to the report, in 2010, total spending (public and private) on health care services in Alaska was $7.5 billion, which is more than $10,000 per resident annually. By now, 2014, that cost would have increased stated William Streur, Commissioner of the Alaska Department of Health and Social Services, in his report.

Streur stated in the report, "It is a sign of the dysfunction of the existing health care system in our country that, despite spending more than $10,000 per resident, there remain gaps in services for some."

The analysis found that through a combination of tribal health organizations, community and federally qualified health centers, locally delivered public health services, and hospitals, Alaskans without health care coverage can access a comprehensive set of services in over 200 communities throughout the state.

One finding within the gap population reported a number of Alaskans between 18 and 64 years of age have no desire or perceived need for health care services and do not show up in any counts, studies, or surveys. According to the report, this group simply will not seek out health care services, except in perceived emergencies where they are admitted and treated. The only way to derive an estimate of this group is through a process of elimination, after identifying all other groups seeking health care. Accordingly, while the analysis uses 10,000-12,000 as an estimated number of individuals in the gap population, the number of those who would actually utilize services is likely much lower.

According to the report, hundreds of millions of public dollars are spent each year in an attempt to provide funding for safety net services in Alaska, yet uncompensated care is identified as a burden by much of the private and tribal health systems. A need was identified to better understand how hundreds of millions of dollars are spent each year in an attempt to provide coverage to the gap population, yet uncompensated care is identified as a significant burden by much of the private and tribal health systems.

The report identified gaps in services, many of which are related to specialty and inpatient care, and illustrate the importance of charity care and financial assistance in the existing safety net.

“Gaps exist, but they are more limited than what is perceived,” said Commissioner Streur. “Like Governor Parnell, I remain committed to funding the safety net of health care services already available to Alaskans who do not qualify for Medicaid, yet cannot afford private insurance.”

The Governor requested this analysis in November, when he announced the formation of the Medicaid Reform Advisory Group (MRAG), which will meet regularly over the next seven months to review the existing Medicaid program and provide recommendations for reform.

“I believe this analysis will inform the group’s future deliberations,” said Commissioner Streur. “And in turn, I expect their work and recommendations will further our understanding of opportunities to provide coverage for service gaps identified in this report.”

On the Web:

Gap Analysis Report(45 pages)
http://dhss.alaska.gov/Commissioner/Documents/MedicaidGap/study.pdf

Source of News: 

Alaska Department of Health & Social Services
dhss.alaska.gov

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Ketchikan, Alaska

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