As a lawsuit over Medicaid expansion continues to play out in court, six legislators met Thursday on separate, party-specific panels and highlighted that the public health care program for low-income Alaskans will again rise as a hot-button and divisive issue during the upcoming legislative session.
The lawmakers divided along party lines in their views on Gov. Bill Walker's decision to expand Medicaid and the lawsuit filed by the Legislature that soon followed. But where lawmakers could agree at the annual State of Reform Health Policy Conference in downtown Anchorage is that changes must be made to the existing Medicaid program. The question of what changes remains.
"One thing we all agreed on accepting is reform," said Gov. Bill Walker, a keynote speaker at Thursday's conference. "Reform is absolutely, absolutely critical. I think this session, I know this session, there will be bills on reform. We're working on one. I know the Legislature is working on some. We'll work on combining our efforts."
Walker, a Republican-turned-independent, campaigned last year on the promise to accept Medicaid expansion, extending the health care program to low-income, single Alaskans under President Barack Obama's health care law. His opponent, incumbent Sean Parnell, had refused to expand Medicaid.
After Walker won the election, he introduced legislation that would expand and reform the health care program. However, after a regular legislative session and two special sessions, lawmakers never voted on the bills.
In July, Walker announced he would use his executive power to expand Medicaid and in August the Legislative Council, acting on behalf of state lawmakers, sued him and voted to spend up to $450,000 on two law firms to represent the Legislature in the suit.
Sen. John Coghill, R-North Pole, who sits on the Legislative Council, said Thursday that Medicaid costs the state more than $700 million a year, a rising cost he labeled as unsustainable. He said when looking at reform he wants to examine how people can get themselves out of the Medicaid program and into the health insurance market.
"Is there an incentive for them to work into the workplace or is there an incentive for them to never get out of Medicaid?" Coghill said.
Sen. Pete Kelly, R-Fairbanks, and Sen. Cathy Giessel, R-Anchorage, also sat on the panel and decried Medicaid as a huge cost driver of the state budget.
Kelly proposed a bill last session that didn't pass out of committee, but sought to reform Medicaid. It called for the expansion of telemedicine, enhancement of fraud prevention and the exploration of privatizing the Alaska Psychiatric Institute, Alaska Pioneer Homes and facilities of the Division of Juvenile Justice, among other initiatives.
He said he wanted the bill to hold in committee last session, so it could be again considered during the upcoming session. "It gets pretty close to hitting some home runs," he said. "It looks quite differently at how we look at Medicaid moving forward."
During the Democrat's panel, Rep. Les Gara, D-Anchorage, denounced the Medicaid lawsuit and criticized legislators who have failed to pass any legislation to reform the health care program over the past several years.
Walker's bills, he noted, included cost-saving reforms to Medicaid, but lawmakers never got the chance to cast their votes on them.
"You kept hearing the same line, 'We're not doing Medicaid expansion without reform,' but there was reform they could've passed or at least that they could have allowed a vote on," Gara said. Walker's bill, he said, had more than 30 hearings last session. "Don't complain you don't have the facts when you could have the facts by just reading the bill," he said.
Gara, Sen. Bill Wielechowski, D-Anchorage, and Rep. Chris Tuck, D-Anchorage, all say that Medicaid expansion will save Alaska millions of dollars, bring thousands of jobs, and with more Alaskans insured, more health care facilities will see bills paid.
Tuck said the Medicaid lawsuit does not represent the will of all lawmakers and spending public dollars on it "is the wrong use of Alaska's money." The public must continue to speak out against it, he said.
Coghill said that lawmakers will ask for summary judgment in the lawsuit.
The health care policy conference was the fifth hosted in Anchorage by DJ Wilson and his strategy firm Wilson Strategic. Wilson, based in Seattle, hosts the conferences in a number of states. Alaska's 2015 conference had a broader engagement of lawmakers than years past, Wilson said.
"I think I see a real hardening of the positions, but I also hear from legislators that they really are yearning for a place to have these constructive conversations," he said.
Alaska Dispatch Publishing