Alaska Democrats push for release of report on Medicaid expansion

Lisa Demer

With the federal government largely shut down over Republican opposition to the federal health care law, Democratic state senators here are pushing for release of a new study of the cost of insuring the poorest Alaskans.

Gov. Sean Parnell has resisted the biggest part of the Affordable Care Act, expanding the pool of people eligible for state Medicaid, a joint state-federal insurance program that serves those with no or low income. Aides say Parnell will decide whether to recommend a Medicaid expansion by Dec. 15, when his budget proposal for next year is due to the Legislature.

Among other changes, for the first time Alaska adults without children at home could get health care through Medicaid. The Alaska Native Tribal Health Consortium estimates that 40,000 uninsured Alaskans could be covered.

The new health care law saw a shaky startup this week as people shopped for insurance on overloaded web sites. The law envisioned that a Medicaid expansion would fulfill a requirement that everyone have insurance, even those too poor to afford private policies. But the U.S. Supreme Court ruled that states could choose whether to expand Medicaid. So far, half have decided to do so, according to the Kaiser Family Foundation.

Parnell has yet to decide whether Alaska will join them.

The state Department of Health and Social Services last year contracted with The Lewin Group, a Virginia-based health care consultant, to perform a nearly $80,000 study to examine the costs of expanding Medicaid through June 2020.

Among other things, the analysis was supposed to evaluate the costs of adding people by age, gender, health status and socio-economic status. The consultants also were supposed to look at how many people might lower their incomes to qualify and how many who are already eligible would sign up because of the federal law's requirement that everyone have insurance.

The study also was to consider whether the state might be able to cut or eliminate existing health programs if people had Medicaid.

The federal government has agreed to pay for 100 percent of the expansion costs for the first three years, then phase down to 90 percent by 2020. The Native health consortium estimated the state could spend as little as $24 million over seven years to cover the needy through Medicaid.

Though the final study was delivered to the department April 12, the state has refused to release it. Parnell has yet to be briefed on it by his health commissioner, William Streur, according to his spokeswoman, Sharon Leighow. The document doesn't have to be disclosed because it's in the realm of "deliberative process," an exemption allowed under law, she said.

Sen. Bill Wielechowski last week began criticizing the Parnell administration for withholding the document and on Friday he and the other three Anchorage Democrats in the Senate sent Parnell a letter urging the study be finalized and made public.

"It is critically important for legislators, as well as the public, to have access to the information the administration is using to make its decision with regards to the Medicaid expansion," said the letter signed by Wielechowski, Berta Gardner, Johnny Ellis and Hollis French. "We fear that partisan politics and a lack of leadership on this issue will leave Alaskans with many more questions than answers about health care reform."

On Friday, Streur rejected a request for the report from the Daily News on the same "deliberative process" grounds. 

Josh Applebee, the state's deputy director for health care policy, said The Lewin Group's study provided background material and numbers the department is using to develop recommendations for the governor.

"This process is not easy, nor is it cut and dry and it's far from a 'no brainer,' " Applebee wrote in an email Friday. "There are multiple facets -- causes and effects -- that need to be considered."

The department intends to make its recommendation to the governor very soon, he said.

Reach Lisa Demer at or 257-4390.


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