The federal government announced Thursday that two Alaska nonprofits are receiving grants to help Alaskans, particularly those without medical insurance, find their way around the Affordable Care Act.
With enrollment beginning Oct. 1 and coverage starting Jan. 1, activity around Obamacare is heating up, but the state of Alaska is all but absent as the only state in the Northwest region to not establish an insurance market, ceding that ground to the federal government.
"It's not fair to Alaskans not to have anything, so where that choice has been abdicated by the state, we come in and run the marketplace," said Susan Johnson, Northwest regional director of the U.S. Dept. of Health and Human Services.
Johnson, whose office is in Seattle, was in Anchorage on Thursday to announce the two "Navigator" grants at a news conference and to explain what she conceded is a complex federal health-care program passed by Congress in 2010.
The grants announced Thursday, each for about $300,000, went to United Way of Anchorage, for urban Alaska, and the Alaska Native Tribal Health Consortium, for rural areas. Spokeswomen for both organizations said they plan to work together and use their established networks to promote the insurance markets.
"You want to talk to somebody who looks like you, thinks like you, and that you know," said Johnson, explaining how the agencies will try to make consumers comfortable with the new system.
Republicans continue to fight Obamacare, and Gov. Sean Parnell has pulled the state from two key provisions: the insurance exchange or marketplace, where private insurers would compete for Alaskans' business, and Medicaid expansion that would include more low-income residents in the subsidized health-care program.
Parnell has said he would reconsider his decision on Medicaid expansion in the budget he presents the Legislature in January.
As long as Medicaid expansion occurs by March 2014, Alaska can still get 100 percent reimbursement from the federal government, according to Health and Human Services spokeswoman Carrie Glover.
Parnell has said he doesn't trust the federal government to continue to reimburse Alaska for the extra costs, leaving a burden on the state budget into the future.
But his decision has already become an election issue in the 2014 governor's race, with independent Republican Bill Walker and Democrat Hollis French criticizing Parnell's position on Medicaid.
"That effects potentially 40,000 Alaskans," Johnson said. "We're hopeful the governor is considering this, and with all the information he has, that he will make that decision for Alaskans."
Some provisions of the Affordable Care Act have already taken hold, many affecting people who already have health insurance.
"Since the law passed, 270,000 Alaskans are free from worrying about a lifetime limit on their coverage, which could've snatched away their ability for insurance and services just when they needed it the most, in the course of chemotherapy or some such," Johnson said. "Since the law passed, 164,000 Alaska with private insurance have gained access to preventive services without co-payments," she added. That gives people an incentive to see a doctor "to be healthier, to live longer, and not to wait till a disease has taken foot and has to be managed."
The insurance marketplace is another important part of the law, Johnson said. Two of the four states in her region have embraced it, with Oregon calling its program "Cover Oregon" and Washington terming it "Healthplanfinder." An Oregon songwriter wrote a jingle that has people singing, "Long Live Oregonians," said Johnson, who half-sang the refrain herself.
Idaho, which is even more solidly Republican than Alaska, reluctantly established a marketplace so it could "do it the Idaho way," Johnson said.
In marketplace states, the states themselves drum up publicity and do public outreach with the help of federal grant money. In the 30-or-so states like Alaska, the federal government gives grants to "Navigators" to promote the exchanges.
In the meantime, the main outreach tool is the Department of Health and Human Service's website, healthcare.gov, and its toll free number, 800-318-2596. Among the languages spoken at the toll-free number is Yup'ik, Johnson said. The "Navigators" will assist people who don't have computers or who want to apply for insurance using paper forms.
So far, two insurance companies are signed up for the Alaska marketplace and a third may join them, Johnson said. Rates are not yet set, though she expected them to be listed by Oct. 1. On the exchanges, companies are required to disclose their costs and benefits in established categories, so consumers can more easily compare programs.
Open enrollment begins Oct. 1 and extends through March 31, 2014, with coverage beginning Jan. 1, 2014.
Reach Richard Mauer at firstname.lastname@example.org or 257-4345.
By RICHARD MAUER