Alaska News

Health care for thousands at stake in Alaska governor's Medicaid decision

Gov. Sean Parnell, who has actively fought the Affordable Care Act, on Thursday said, among other things, that he would consider whether or not the state of Alaska would opt out of expanding Medicaid, a cornerstone of the law's efforts to expand health insurance access to most Americans.

Parnell's fight against what he calls federal intrusion into state affairs has been a hallmark of his administration. He's ordered his various hand-picked attorney generals to sue the Feds on a long list of issues perceived by the current administration as violating state sovereignty.

In 2010, then-Attorney General Dan Sullivan joined 20 other states to sue over the bill. Six other states followed. "Health insurance at the price of freedom? No," Parnell, who gets some of the best insurance available in Alaska, paid for by the state, said at the time.

Opponents of the health-care law, many of whom also get great, taxpayer-funded insurance benefits, are urging Republican governors to refuse the new Medicaid insurance reforms. Alaska Rep. Don Young and Sen. Lisa Murkowski strenuously opposed health reform. They were traveling Friday and unable to comment on whether they supported or opposed Medicaid expansion for Alaskans.

Sen. Mark Begich, a Democrat who has supported the bill, said that "Because the states will never pay more than 10 cents on the dollar for this coverage, it is a very good deal."

Provided that all states participated, the Medicaid expansion would cover roughly 16 million people across the country -- and roughly 32,000 Alaskans -- by 2014, the time when the Medicaid provision of the law would be enacted. The federal government will cover all of the costs of that expansion for the first five years. By 2020, the states will pick up about 10 percent of the costs.

The health-care law originally sought to coerce states into expanding Medicaid to everyone who makes up to 133 percent of the federal poverty level. States that refused to go along with the expansion would have been denied federal Medicaid funding. However, in the Supreme Court ruling that upheld health reform, the justices also found that such coercion was unconstitutional. Now, the states can decide whether or not to enact the Medicaid expansion.

ADVERTISEMENT

The question of whether Parnell will or will not opt out is a particularly important one for Alaska. Currently, about 125,000 Alaskans are without insurance. Because health care is so expensive here -- more expensive than anywhere else in the country -- many who are insured only have catastrophic coverage.

As it currently stands in Alaska, those who don't receive coverage from their workplace have few options. They can buy from the private market, or if they have a pre-existing condition, they can buy insurance through the state's high risk pool. A 40-year-old, say, who had a heart condition, would pay $1,119 per month for such insurance with a $1,000 deductable. There's also a federal program for those with pre-existing conditions. A 40-year-old uninsured person under that program, who hasn't been insured for at least six months, can expect to pay $813 per month with a $1,500 deductible.

Currently, Medicaid medical coverage is only available for pregnant women, disabled adults or senior citizens, all of whom must make under a certain amount of money each month.

Under the expansion, beginning in 2014 Medicaid would cover everyone with incomes up to 133 percent of the federal poverty level. Currently in Alaska, that's $18,580 for an individual.

Alaskans would remain uninsurable without Medicaid expansion

If Parnell opts out of expanding Medicaid -- and if the Legislature doesn't challenge him -- many of those who would qualify will remain uninsured.

One of those people who would likely qualify for Medicaid, who can't get insurance now, is Vicki Penwell's son. Penwell is the Alaska representative for the National Patient Advocate Foundation, a nonprofit advocating for patient-center reforms.

Penwell got involved in the organization because of her son, who has cystic fibrosis, a disease passed down through families that causes thick, sticky mucus to build up in the lungs, digestive tract, and other areas of the body.

He was diagnosed with CF when he was 5, and got kicked off of his parent's insurance when he turned 18. Since then, he hasn't been able to find a job that he can work that will provide such insurance. He's 28 now. However, because he does want to work, and does so, he makes too much money to qualify for Medicaid, but not enough to be part of the high risk insurance pool. He needs preventative care, but often waits until he's sick enough to go to the emergency room.

Penwell said her son is not at all unique. These are the kinds of stories she hears all the time, from hundreds of Alaskans.

In 2014, when the Medicaid component would kick in, Penwell is convinced her son will qualify.

"It will make him a happier person, a more active, contributing part of society. It will save my son's life," she said.

Contact Amanda Coyne at Amanda@alaskadispatch.com

ADVERTISEMENT