A friend of mine died the other day. He had recently had a huge cancerous tumor removed from his chest, and after returning home to recover, had suffered internal bleeding and passed away. He was a larger-than-life man, full of laughter and stories, the kind of person you run into everywhere who knows everyone.
What my friend didn't have was medical insurance. Like so many Alaskans, he pieced together a living in a variety of fashions, none of them providing health care. When he started feeling twinges of pain in his abdomen, he had to choose between going to the doctor and filling up the fuel tank that kept his family warm. He chose the latter. Last year, when the Affordable Care Act came along, he gratefully signed up. As soon as he got his card in the mail, he went down to the doctor's office. A flurry of tests followed, a lot of bad news, research, more tests, and a long trip to medical centers in the Lower 48 to remove the growth that was taking over his body. For my friend, the national health care plan came too late. Now, because of politics and the actions of the Alaska Legislature, many more people may be in the same position.
While the Affordable Care Act allows individuals to purchase health care now, the premiums for Alaskans have soared, putting the cost for those who do not qualify for reduced premiums out of reach for many. A single, middle-aged person who started out paying about $400 a month for insurance has seen that rate jump 40 percent this year, and there is a another projected 25 percent increase next year. It's still less than buying insurance used to be, but not by much. But those costs would be greatly mitigated if our state accepts the federal expansion of Medicaid. In many cases, the Medicaid expansion would cut the insurance premium costs in half or more, putting them back into the realm of reason.
The rationale many have used for not accepting Medicaid expansion is that there is no guarantee the federal government will continue to fund it at a significant level -- states sign up and get nearly complete funding the first few years, but each year, states are asked to take more responsibility for covering the cost of the expansion. While that may be true, turning down this federal money for fear that covering the cost of caring properly for the state's low-income residents will become overly burdensome is heinous and shortsighted. Sick people cost the state money, one way or another. They are unable to contribute positively to our economy, they depend on other social assistance programs more heavily, and often times, they eventually fall below the income levels that kept them from getting coverage anyway. But in cases like that of my friend, by the time they get to that point, it will be too late.
Gov. Bill Walker's campaign centered around accepting Medicaid expansion. He listed it as his No. 1 priority on arriving in Juneau. And yet, he has been thwarted in that effort by the Legislature. To date, it continues to be held out as a political pawn, with both sides trying to get their way without alienating the other completely.
Recent legal opinions, one from the Alaska Department of Law and another from the Legislature's own legal counsel, have called the Legislature's attempt to block Walker from accepting the federal funds for Medicaid expansion unconstitutional. Technically, Walker could take the estimated $130 million in federal funds with or without the Legislature, the legal opinions stated. So far, the Walker administration says its not ready to do that, but it's hard for the average person to see what he has to lose. It's quite a bit easier to see what the estimated 20,000 or more low-income Alaskans, who would finally be fully covered for free, have to lose. And many more wait in the wings, paying the tax penalty for not signing up for Obamacare this year because it is just too expensive.
Politicians who opposed Obamacare for party-line reasons are quick to point out that Alaska is getting the short end of the stick with this program, paying far more than Lower 48 residents do.
But that goes for just about everything in Alaska. It's just more expensive here. And hopefully, some of those kinks will get federal attention in the future. The bottom line is the program, as the federal government designed it, still provides medical insurance that thousands can afford for the first time. Let's hope the governor takes a stand and does what he was elected to do, with or without the Legislature. It came too late for my friend, but there are thousands more who need him to take action.
Carey Restino is the editor of Bristol Bay Times-Dutch Harbor Fisherman and The Arctic Sounder, where this commentary first appeared.
The views expressed here are the writer's own and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email commentary(at)alaskadispatch.com.