Gov. Sean Parnell's decision not to expand Medicaid and not accept millions of federal dollars to pay for it is shortsighted. His decision in 2010 to join with other Republican governors to overturn the federal Affordable Care Act was a money-wasting effort when the Supreme Court refused to find the ACA unconstitutional. In early 2011, Parnell refused to set up a statewide marketplace that would provide thousands of Alaskans easy access to affordable health insurance. Fortunately, the federal government will help Alaskans get that coverage anyway, and for Alaskan women, this is critically important.
The Affordable Care Act (ACA) ensures most American citizens access to affordable and comprehensive health care. Young people may stay on a parent's health insurance until age 26, children and adults with preexisting conditions may no longer be denied coverage, insurance providers may no longer cancel or drop coverage when their insured customers become sick, and the law prohibits lifetime limits on most benefits (NWLC.org).
The ACA is the most expansive development in women's health care in a generation. Discrimination against women with higher premiums or denial of maternity coverage is prohibited. Reproductive services including cervical exams and cancer screenings, maternity care, birth control, and breast-feeding support and supplies are newly covered as mandatory preventive care, available to women with no co-pays or deductible costs. Domestic violence (DV) screening and counseling is also covered as preventive services. This change in the law has already benefited millions of women, including approximately 60,000 Alaska women in 2011 and 2012 (NWLC.org).
The ACA's DV provisions especially benefit Alaska, where a recent UAA Justice Department survey reveals that a disproportionately high number of Alaska women, more than half, have experienced intimate partner sexual violence and/or domestic violence in their lifetimes.
Typical DV batterers use harassment, sabotage, isolation, neglect, threats of harm, violence, and financial manipulation to entrap their victims. The ACA's health coverage will provide trapped, battered Alaska women increased financial security that could empower them to escape their lives of servitude, submission, despair, and injury, as well as take their children out of their atrocious environment of maltreatment and violence, perpetrated by Alaska batterers.
Unfortunately, Alaska's Governor Parnell has joined other states, with mostly Republican governors, who attempt to obstruct or sabotage the ACA's implementation whenever possible. In addition to the failed lawsuit and failure to provide Alaskans their own federally funded marketplace, Governor Parnell again joined 24 of those governors and decided to not expand Medicaid, with 100 percent federal funding in 2014. His decision effectively sabotaged the ACA's coverage of uncompensated care costs for about 40,000 impoverished Alaskans, continuing to pass those costs on to insured Alaskans in 2014.
In his announcement, the governor often stated that he and his administration needed more time, a year, to gather more data, develop "a better understanding" of uncompensated care and access, and "craft a proposal" for an alternative plan to expansion. That doesn't make sense, given that he could expand now, take the 100 percent federal coverage for costs, cover all Alaskans, and when he gets that information, he could opt out or continue the expansion based on real facts.
Governor Parnell also reasoned that he would not accept the billions of dollars in federal coverage because "there is no guarantee" the U.S. government will not "cut and run." That's also odd. He's telling us that to receive billions from the U.S. government, he needs additional guarantees. But he needed and received no guarantees when he gave oil companies billions in tax credits for increased oil production.
Despite all that, there is still some hope for uncompensated care costs for the extremely poor. There is always next year, when we can hope that either Gov. Parnell or a new governor will have all their facts, better understand the issue, and join the currently 25 other states and the District of Columbia that sensibly chose to expand Medicaid for 2014.
Barbara McDaniel is a lifelong Alaska resident and President of the Alaska National Organization for Women (NOW) chapter.
By BARBARA MCDANIEL