Compass: Alaskans should join Medicaid discussion

A recent compass piece asked where informed discussion could be found on Medicaid issues in Alaska? Contrary to the authors' assertions, when Gov. Parnell announced last November that Alaska would not accept the Obamacare Medicaid expansion, he also announced the formation of a Medicaid Reform Advisory Group.

As chair of this group, I am committed to an open and public process that serves as a way to hold a comprehensive discussion about Alaska's Medicaid program. The meeting documents will be public, and I strongly encourage participation by the public and stakeholder groups in this important conversation.

Medicaid is complicated -- there is simply no way around it. Although it serves as a critical safety net for over 150,000 eligible Alaskans, it is also an expensive, complex and often confusing program. Total Medicaid spending at the state and federal level in fiscal year 2014 was $1.6 billion, with $700 million of that coming from state general funds. In total, Medicaid spending accounted for 13 percent of the state's operating budget in that same year.

Decisions surrounding a program this complex do not fit neatly into a 30-second sound bite, or even a 120-minute committee hearing. Any changes or expansions to this program have tremendous long-term fiscal and social impacts that require careful analysis, public input and legislative support.

The Parnell administration is committed to having a full and open discussion about Medicaid and any expansion. However, any discussion of expansion cannot occur independently from the Medicaid program at-large. Expansion must be considered under the broader umbrella of Medicaid reform.

The Medicaid Reform Advisory Group's main focus will be the larger challenge of overall reform to Alaska's Medicaid system.

Specifically, the governor charged the group with evaluating three different mandates: providing whole care for the patient by uniting physical and behavioral health; stability and predictability in budgeting; and increasing the efficiency of navigating the system by providers.

Hundreds of Alaskans have already engaged in this conversation. In order to continue the public process, the state Department of Health and Social Services) has a dedicated email address to collect input and suggestions. If you want to provide input or express your viewpoint, please email

The issue of access to health care is very serious, and, like Gov. Parnell, I remain committed to funding the safety net of health care services already available to Alaskans who do not qualify for Medicaid, yet cannot afford private insurance.

While these services may not meet every need in every community, they do provide a robust safety net that we need to better understand before committing billions more in state and federal tax-payer dollars.

We will continue to be responsive and provide any assistance we can to connect Alaskans in need of health care to services for which they qualify. Feel free to contact us at 907-465-3500, or the Department of Health and Social Services directly at 907-465-3030 in Juneau, or 907-269-7800 in Anchorage if we can help answer any specific questions.

William J. Streur is commissioner of the Alaska Department of Health and Social Services.