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Compass: Governor makes the right call in rejecting Medicaid expansion

Recently, a number of stories and opinion pieces in the Anchorage Daily News made the case for Gov. Parnell changing his mind and signing Alaska up for expanded Medicaid under the Affordable Care Act (Obamacare). This expansion would primarily add lower-income single men, without dependents, to the roster. Denali KidCare already covers many kids, pregnant women and families (family of two-income limit of $33,000, $9,000 more per additional person).

Concern for the welfare of single men isn't driving supporters. More federal money for Alaska is. This is a siren call we rarely fail to answer but this time I think we should.

The federal government promises to pay 1 percent of the expansion's premiums the first two years and 90 percent after that (only for new enrollees). Consider, however, Medicaid currently costs $450 billion a year, and the federal government is broke. Other important promises and assurances involved with Obamacare have already been broken. More will go by the wayside as the employer's mandate kicks in and union waivers expire. If this promise is reneged on Alaska will be left footing the bill for expanded Medicaid.

However, let's assume President Obama will see it's kept ... for three years. After that might some future Congress or president change the distribution? Might our two huge piles of money (Permanent Fund and General Reserve) catch the attention of states with big debt problems and larger congressional delegations? Might they suggest Alaska is rich enough to pay a larger share? Isn't that a goal of Obamacare, cost sharing? Why only among people? Why not between states?

A major point behind the ADN's editorial in favor of expansion is the support of the state Chamber of Commerce. In Richard Mauer's story on Oct. 24, he quotes Karen Perdue, CEO of the Alaska State Hospital and Nursing Home Association, stating the vote in favor was "overwhelming."

Only 150 of the 700 members, or 21 percent of total membership, attended that Fairbanks meeting. Such votes are interesting but hardly dispositive of deep support. Still, the ADN's editorial lauds this vote, declaring "Chamber members put business sense before any ideology in their decision." Absolutely. Businesses do that daily. Perhaps many supporters, like Ms. Perdue, have a stake in increasing funding sources to health-care providers.

This self-interest doesn't necessarily make it a bad idea but it should give pause. It's just an urban legend that all business is fiscally conservative and against big government. Generally speaking businesses are against higher taxes but businesses are really interested in profit. For some, if that's through the government purse, no problem.

Mauer also quoted Rachael Petro, the new president of the chamber. Her previous professional work was in the corridors of government. Considering government's ever-increasing role in the day-to-day life of a business, she probably was a good choice. However, she's clearly someone trained to look first to government for a solution.

Another voice in favor is Sen. Begich. Call me a cynic but I think the good senator hopes to find another Alaskan politician to share the responsibility of the ACA. He was, you will recall, the final vote for passage. Without him Obamacare wouldn't exist. Without him the visceral anger and worry that is sweeping the nation wouldn't exist. Without him there wouldn't be 1,000 Alaskans losing coverage for every one who has enrolled (but not paid) in Obamacare. I understand why he'd try to drag Parnell aboard as the train races for the cliff. I also understand why the governor won't hop on.

We all want to help those who need assistance but government needs to be fiscally responsible, both in the short and long run, or eventually it can help no one. Additionally, government is not the only source for aid. Family, friends, churches and organizations can help and often do a better job for individuals. We seem to have forgotten that, as we have the fact that though some citizens have no health insurance, no one is without health care. Don't conflate the two.

Joann Pantages is an occasional Compass contributor. She lives in Anchorage.



By JOANN PANTAGES