October 27, 2014
Monday PM

Last November, Sean Parnell denied basic health care coverage to thousands of Alaskans when he announced Alaska would not participate in Medicaid expansion to allow anyone with an income of up to 138 percent of the federal poverty level to qualify for insurance coverage. An Alaskan making $18,580 or less or a family of four making less than $38,330 would have qualified.

Parnell’s decision was disappointing. The business, health care, and faith-based communities support Medicaid expansion, including the Anchorage Chamber of Commerce, the Alaska State Hospital and Nursing Home Association, the Alaska Native Tribal Health Consortium (ANTHC), and Anchorage Faith & Action Congregations Together. To placate critics, Parnell formed a Medicaid reform advisory group, rather than using two existing advisory bodies with similar missions, the Medical Care Advisory Committee and the Alaska Health Care Commission.

The new third group has met five times since April, but little is known about its progress, since minutes are not posted publicly. Apparently, Medicaid expansion is not one of the reforms it is permitted to review. Earlier this month, Parnell said he was considering state purchase of insurance for the thousands in the coverage gap. Conveniently for Parnell, Alaskans won’t know the recommendations of the group or their costs until after the election.

I would have voted against Obamacare had I been in Congress. But it is the law of the land, upheld by the United States Supreme Court. Let’s move ahead together, work practically, and serve the best interests of Alaskans under the existing federal system.

An ANTHC-commissioned report released last year estimated expansion would give 41,500 uninsured Alaskans, including 15,700 Alaska Natives, access to basic health care coverage. A Parnell Administration-commissioned report by the Lewin Group estimated there would be a net increase of approximately 40,000 Alaskans.

Typically, uninsured Alaskans postpone paying out of pocket for health care until things get so bad they end up in the emergency room. Going to the ER out of desperation is not a health care plan.

We need to get as many of those people covered as we can, and not just because it’s the morally decent thing to do. We all pay the costs of those ER visits. Extending basic health care coverage to more Alaskans means more people will get preventive care and not fall back on the ER.

Aside from the thousands of Alaskans who would benefit, expansion would vastly strengthen Alaska’s health care infrastructure. Over the next seven years Alaska would see $1.1 billion in new federal revenue for Alaska, 4,000 new jobs, $1.2 billion more in wages and salaries paid to Alaskans, and $2.49 billion in increased economic activity throughout the state. And the cost of Medicaid expansion would be borne entirely by the federal government during its first three years, and at 90 percent thereafter.

Parnell’s response has been to try to minimize the estimate of the number of people who need coverage. In June, the Alaska Department of Health and Human Services pegged the number of people who truly lack any coverage for health care at between 10,000 and 12,000. This contrasts with three other contemporaneous reports. The Alaska Legislative Research Services estimated the number of additional persons who would be covered at 34,901. The Kaiser Family Foundation estimated nearly 140,000 Alaskans were without health care coverage. And the U.S. Council of Economic Advisors, using a lower percent of poverty, concluded an additional 26,000 Alaskans would be covered by Medicaid expansion. We can quibble over the numbers and the levels of coverage, but there is no dispute: thousands of Alaskans are without coverage. In 21st century Alaska, this should be scandalous by any measure.
In the waning weeks of this gubernatorial campaign, partisans will try to equate Medicaid expansion and Obamacare. Alaskans won’t be fooled by that tactic. Whatever the merits of Obamacare, Alaskans overwhelmingly support making sure our least fortunate citizens have accessible health care. Conservative governors who initially rejected Medicaid expansion funds for their states – including Michigan, Ohio, Pennsylvania, Tennessee, Utah, and Wyoming – have since been persuaded the public interest best aligns with expansion. In their experience, everyone’s health care costs have gone down following Medicaid expansion, and that’s a good thing.
I hope the reform advisory group produces helpful recommendations—not just cost cutting measures, but actual mechanisms for delivering health care to Alaskans who today are without adequate coverage. Only in that way does the state have any prayer of achieving the Parnell Administration’s stated goal: “by 2025 Alaskans will be the healthiest people in the nation and have access to the highest quality, most affordable health care.”

That’s an admirable goal, but under Sean Parnell, it is a distant goal indeed. Let’s change that.

Bill Walker
Anchorage , Alaska

Received October 27, 2014 - Published October 27, 2014

Viewpoints - Opinion Letters:

Webmail Your Opinion Letter to the Editor

 

SitNews ©2014
Stories In The News
Ketchikan, Alaska

Articles & photographs that appear in SitNews may be protected by copyright and may not be reprinted without written permission from and payment of any required fees to the proper sources. E-mail your news & photos to editor@sitnews.us Photographers choosing to submit photographs for publication to SitNews are in doing so granting their permission for publication and for archiving. SitNews does not sell photographs. All requests for purchasing a photograph will be emailed to the photographer.