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Alaska health commissioner defends withholding report analyzing Medicaid expansion

Pat Forgey
Health and Social Services Commissioner Bill Streur provided some hints of what’s contained in the secret Lewin report, saying other privately produced reports on Medicaid expansion show a much lower cost to the state than the Lewin report does. 401(K)2013 / cc via flickr

JUNEAU -- Commissioner Bill Streur of Alaska's Department of Health and Social Services told legislators for the first time Friday why he wouldn't give them, or anyone else, a report the state commissioned on expanding Medicaid in Alaska.

Streur has had the report by the Lewin Group since March. He told legislators that it was in their own interest that he not give them the publicly funded report. It will be made public, he said, when Gov. Sean Parnell releases his budget proposal in mid-December, which will also include Parnell’s decision on whether to expand Medicaid.

It's simply taking that long to analyze the report, Streur told members of the Senate Finance Committee.

"It's about getting it right for you," he said.

The expansion of Medicaid eligibility from the poverty line to up to 138 percent above that line would increase availability of health care to thousands of Alaskans, at a cost of millions of dollars to the state general fund. How many Alaskans would be covered and at what cost are questions that the report is expected to answer.

Previously, Streur had refused to say why he was withholding the report from legislators or the public, but when questioned about it Friday, he provided a reason.

"I don't want to put that out there so people can throw rocks at numbers that we haven't vetted," he said.

The administration's reason for withholding the report is separate from its claimed exemption under Alaska's Public Records Act. They have previously cited the deliberative process privilege in denying the report.

Streur didn't say who might be throwing those rocks, but a number of Democratic legislators have urged Parnell to reverse his earlier refusal to accept the expansion.

Further, community and health-care groups -- including the Alaska State Chamber of Commerce -- have all urged expansion.

The Affordable Care Act, commonly called Obamacare, includes a largely federally funded expansion of Medicaid, the health coverage program for the poor.

After the Affordable Care Act was challenged in court by Parnell and other Republican governors, the U.S. Supreme Court upheld most of the act, but said states could decide whether or not to accept the additional Medicaid dollars. Parnell was one of the governors who refused the expansion last year, but the advocates are hoping the pressure and new information will result in a reversal.

Streur provided some hints of what’s contained in the Lewin report, saying other privately produced reports on Medicaid expansion show a much lower cost to the state than the Lewin report does.

The Lewin report shows costs to the state, in some cases three times higher than the other reports, according to Streur. For example, he said hypothetically, where other analysts might have estimated state costs at $90 million over several years, Lewin might have foreseen a cost of $240 million.

Those disparities are still being analyzed, he said. Streur has previously suggested those other reports were biased in favor of expansion.

Contact Pat Forgey at pat(at)alaskadispatch.com