Alaska Democrats propose their own Medicaid expansion

rmauer@adn.comJanuary 30, 2014 

The Alaska State Capitol is seen in this archive photo. Democrats on Thursday introduced a bill to force the state to participate in the Affordable Care Act's Medicaid expansion provision.

CHRIS MILLER — AP

JUNEAU -- The Legislature's Democrats made good on their promise to attempt Medicaid expansion in Alaska rolling out legislation Thursday to increase coverage for about 41,500 uninsured, low-income Alaskans and override a decision by Gov. Sean Parnell.

In introducing companion Senate and House bills at a news conference in the state Capitol, Sen. Bill Wielechowski, D-Anchorage, noted that Republican governors in Arizona, Ohio, New Jersey and other states opted to bring their states into the Obamacare Medicaid program. Parnell rejected expansion in November.

"Conservative governors across the country have recognized that this is the right thing to do and have put the needs of the citizens above politics," Wielechowski said. "So should have Gov. Parnell."

Four other Democrats shared the table with Wielechowski, but no Republicans. Wielechowski said Republicans were invited to support the legislation, but none did, suggesting a difficult road ahead to get anything through the overwhelmingly Republican Legislature.

"We're hopeful they'll come around," said Rep. Andy Josephson, D-Anchorage, the lead sponsor in the House.

The Democratic measure, House Bill 290 and a bill number to be assigned in the Senate, attempts to overcome one of Parnell's objections -- the possible loss of federal reimbursements in the future. The Affordable Care Act promises to reimburse the states for 100 percent of the cost for new Medicaid enrollees through 2016, declining to 90 percent by 2020. Parnell said he was concerned the state would be on the hook for millions of dollars a year if Washington turned off the tap completely.

So the Democratic bill says that if funding ever dropped below 90 percent, Medicaid would contract to its current level, including no coverage for Alaskans without children.

"If 90 cents on the dollar isn't paid, we will opt out," Josephson said.

That wasn't good enough for members of the House Republican majority at their own news conference about an hour later.

Majority Leader Lance Pruitt, an Anchorage Republican who chaired the meeting with reporters, said several of his fellow caucus members considered the bill "a no-go."

He then compared the bill and its sunset provision to handing a reporter a microphone at a press conference and taking it away, or doing the same thing to a child, but with a toy.

Answering a question from Pat Forgey, a reporter for the news website Alaska Dispatch, Pruitt said:

"Let me do something, Pat. We just gave you that mic to talk. What if halfway through your conversation I took it away from you? Are you going to appreciate that? It's disingenuous to give people something and then turn around and take it away. If we're going to have a discussion on Medicaid expansion, we need to have a discussion on Medicaid expansion."

"Maybe it's like a child," Pruitt continued. "You give them something, you give 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 of the best thing for Alaskans."

That last remark, televised on Gavel to Gavel, brought a response from Democratic Party chairman Mike Wenstrup, an attorney in Fairbanks.

"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," Wenstrup said in a prepared statement.

Perhaps anticipating a reaction like Pruitt's, Sen. Berta Gardner, an Anchorage Democrat who attended the earlier news conference, said that even if the federal funds dried up and the Alaska program shrunk, it would still help people who have been delaying medical treatment.

"A lot of people have pent up demand -- they'll get caught up on that," Gardner said. "If they lose coverage afterwards, that will be tragic, and something we'll have to deal with, but the value, even if it's only for a short period, can be immense to individuals and families."

The Democrats described their effort as both moral and economic: Moral for bringing coverage to the uninsured, and economic for helping Alaska businesses and creating jobs.

The Alaska Chamber of Commerce has supported expansion as have the state's hospitals because it would reduce the number of unpaid medical bills and the use of emergency rooms as a primary-care treatment facility.

And if Alaska doesn't take the federal money, another state will, said Josephson.

"Here I think of the late Ted Stevens and what he would make of that," Josephson said, referring to the long-term senator's legendary ability to get earmarks for Alaska. "We would be subsidizing the health care of others."

Sharon Leighow, spokeswoman for Parnell, said the governor continues to oppose Medicaid expansion but is awaiting a report from the Health and Social Services Commissioner William Streur about how the state could extend health coverage to the uninsured. The report is expected to be delivered to Parnell in mid to late February, but won't be made public at that time, Leighow said.

Reach Richard Mauer at rmauer@adn.com or (907) 500-7388.

 

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