Alaska News

Walker presses Medicaid expansion in Alaska as legislators try to cut program cost

JUNEAU -- With one week left in this year's 90-day legislative session, Gov. Bill Walker for the first time hinted at vetoing a bill that would cut the costs of the public Medicaid health care program without expanding it to cover more Alaskans.

Alaska's Medicaid program primarily covers low-income families and residents who are pregnant or disabled. Walker promised during his campaign last year to broaden coverage to an estimated 40,000 low-income Alaskans who earn less than $20,300 annually, or married couples who earn less than $27,500, under provisions of President Barack Obama's Affordable Care Act.

But Republican lawmakers Monday showed no signs of moving forward on Walker's legislation to expand the program, even as they advanced a separate bill to cut Medicaid costs.

The Walker administration says Medicaid expansion will save the state millions of dollars a year by replacing state spending with federal money. But top Republicans in the House and Senate say they want to implement cost-cutting measures for Medicaid before they expand the program, which currently costs the state more than $600 million annually.

In a prepared statement, Walker said he expects the Legislature to act on his own bill before the end of the session, currently scheduled for Sunday, adding that the legislation remains a "very high priority."

"Alaskans have made their support for Medicaid reform and expansion clear through public testimony, independent polls and more than 150 Alaskan organizations whose support is on the record," Walker's statement said. "I will not accept a Medicaid bill that does not include both reform and expansion."

The House Finance Committee heard hours of public testimony Saturday on Walker's legislation to expand the program, with most of the comments favoring his proposal. But the committee's chairs on Monday left Walker's bill off their agenda, instead scheduling a hearing on a new House bill they sponsored that, like a Senate bill introduced earlier, would cut Medicaid costs without expanding it.

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The new House bill was introduced Saturday. It's identical to a Senate version proposed by Sen. Pete Kelly, R-Fairbanks, who's been the Legislature's most vocal critic of Walker's expansion plans.

One House Finance Committee co-chair, Rep. Mark Neuman, R-Big Lake, said the new bill was introduced because "we want to make sure we've got some discussions on Medicaid reform."

"There's quite a few of us, like myself, who feel that before you can accept money for Medicaid you need to make sure that the current system is working," Neuman said in an interview. He referred questions about the timeline for the Medicaid bills to the committee's other co-chair, Rep. Steve Thompson, R-Fairbanks.

Thompson said he's been getting "a lot of pushback from the public." He added that he couldn't answer a question about when the committee would vote on Walker's expansion bill.

"I can't tell you right now," he said. "I don't have any preconceived idea for when."

There was also no hearing scheduled on Walker's Medicaid expansion legislation in the Senate Finance Committee, where the governor's bill was sent after its approval Friday by the Senate's health committee. Three of the health committee's five members supported its passage, including two Republicans: Anchorage Sen. Cathy Giessel, a nurse, and Sitka Sen. Bert Stedman.

Senate President Kevin Meyer, R-Anchorage, said he wants to see Kelly's bill as the primary piece of Medicaid legislation advanced from the finance committee, rather than Walker's. He said that was because Kelly introduced his bill before Walker did.

Walker originally tried to expand Medicaid through the state budget, but Republican-controlled committees rejected that move and the governor ultimately introduced a stand-alone bill.

Meyer said Kelly's bill could be amended to include expansion.

"If we can fix it and expand it, that's ideal," Meyer said in an interview.

The state's health commissioner, Valerie Davidson, said she was discouraged that no hearings had been scheduled Monday on Walker's expansion legislation.

"We're sort of at the end stage of the legislative process where a lot of opportunity for moving forward and the adjournment plan is really in play," she said in an interview Monday morning, after she spoke at a Senate State Affairs Committee hearing on Kelly's bill. "I assume that this is all a part of it."

Davidson said the state's health department is already working on cost-cutting measures and has been for years.

"Reform is not something that starts and ends on a particular date -- you don't go over and flip a switch on the wall and say, 'There, we've reformed,' and then we're done," she said. "For those folks who say we need reform first, I say, 'Great, we've already been doing that.' Let's do expansion now."

Walker's press secretary, Grace Jang, said in an email that "there is still time in the legislative session to get Medicaid reform and expansion through -- whether through amendments to Sen. Kelly's bill or entirely through the governor's bill."

She said Walker's statement that he wouldn't accept a reform bill without expansion was not a threat to veto Kelly's legislation.

Nathaniel Herz

Anchorage-based independent journalist Nathaniel Herz has been a reporter in Alaska for nearly a decade, with stints at the Anchorage Daily News and Alaska Public Media. Read his newsletter, Northern Journal, at natherz.substack.com

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