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Why is Parnell keeping secret state report on Medicaid expansion?

Pat Forgey

JUNEAU -- Gov. Sean Parnell is standing in the way of hundreds of millions of federal dollars that could expand health care to thousands of Alaskans. His administration is also standing in the way of public release of a state-funded Medicaid expansion study that could support – or undermine – his arguments.

Several other Republican governors are also obstructing the Medicaid expansion envisioned by Congress when it passed the Patient Protection and Affordable Care Act. The governors often echo Tea Party sentiments against the health reform law better known as Obamacare.

But while Parnell has opposed other provisions of Obamacare, such a state role in setting up a health care exchange, he's defending his Medicaid decision based on Alaska interests.

Even though the federal government is promising to take on most of the expansion cost – 100 percent of the costs incurred by the 66,000 Alaskans who would be newly eligible for Medicaid and 90 cents on the dollar in later years – Parnell has insisted that the law isn’t assurance enough.

“If we expand the Medicaid population and the federal government fails to keep its financial commitment, the state would likely have to back fill for lost federal dollars to cover beneficiaries of the expansion and to protect the health coverage of everyone currently in the program,” Parnell said in announcing the decision earlier this year.

While Parnell said he actually trusts President Obama to keep funding the health care initiative that's so close to his heart, he's not confident that future administrations would continue to do so.

Obamacare’s future funding makes the expansion too risky a proposition for the state, he said.

That argument and anything else Parnell may have based his decision on is not clear because a study commissioned by the the Department of Health and Social Services that was completed months ago, has still not been released to the public.

The report, titled "An Analysis of the Impact of Medicaid Expansion in Alaska," was compiled by The Lewin Group, a Virginia-based consulting firm, at an expected cost of nearly $80,000.

Friday, Sen. Berta Gardner, D-Anchorage and other Democratic senators sent Parnell a letter outlining why they think he should make the study 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," the request read.

Those legislators and members of the state's health care community who support the Medicaid expansion hope they can still persuade Parnell that expanding Medicaid is good for the state, and that he will include expansion in his Fiscal Year 2015 budget that he is scheduled to release in December.

Parnell himself has fed those hopes, noting that next year's budget is another "decision point" in which the extra federal dollars could be brought to Alaska.

If Parnell reverses course and decides to seek the Medicaid expansion funding after all, and that is approved by the Alaska Legislature, coverage likely could not begin until July 1, 2014.

Sen. Bill Wielechowski, D-Anchorage, working on his own, has been trying to use the state's Public Records Law to unseal the study, which has been kept private by DHSS and its commissioner, Bill Streur.

Wielechowski said it’s important for the public to know what information the Parnell administration is relying on.

The senator’s request was denied by Jason Hooley, a legislative liaison for the Department of Health and Social Services. In the denial, Hooley acknowledged that the Lewin report had been complete since April, but said it "is not yet available for distribution."

Hooley provided no reason or legal justification for the denial, but said it would be made public after Streur makes his recommendation.

The Public Records Law says denials "must state the reasons or the denial, including any specific legal grounds for the denial."

Friday, Streur denied Wielechowski's appeal of the denial, again without citing any reasons.

Streur and other top departmental officials were unavailable for comment Friday, said spokesperson Cathy Stadem.

Without the Lewin report, those watching the issue in Alaska have been instead relying on two studies commissioned by the Alaska Native Tribal Health Consortium which show that the Medicaid expansion would create thousands of new jobs, infuse $1.2 billion in additional Alaska payroll, create $2.49 billion in increased economic activity and, of course, insure 66,000 Alaskans currently uninsured, underinsured or uninsurable.

Contact Pat Forgey at pat(at)alaskadispatch.com