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Study shows Medicaid expansion would bring millions to state

Carey RestinoThe Arctic Sounder

I'll be honest, I'm not really an insurance kind of person. I have car insurance and home insurance, but I resent paying for something on the idea that someday I might need it. It seems somewhat like a scam to me. But in the case of health insurance, the scam counteracts an even bigger scam -- the cost of health care, especially emergency health care.

Ask a few of your friends, and the stories will undoubtedly come up. It cost my friend more than $1,000 to go have his blood pressure checked and treated after he realized, on a Sunday, unfortunately, that it was sky-high. He was in the hospital for about an hour, they took his blood pressure, checked his vitals and gave him some medicine that would help lower his pressure. And for that, he was charged more than the equivalent of a month's worth of groceries.

If hospitals have to roll out the big equipment -- things that see inside you, for example -- or pick up a scalpel, the rates are even higher. And goodness forbid you need any kind of pain-control measures. Your child's college fund will be in deep trouble.

For the uninsured, it's a matter of holding one's breath and hoping you make it with preventative measures -- don't smoke, don't drink too much, and go get exercise every day. But that's no guarantee that sooner or later something won't come up that catches you unaware. Every winter, my children are uninsured for a few months. To continue that insurance would cost thousands of dollars. Other alternatives are just out of reach. I actively avoid bringing my son to hockey games for fear he'll develop an interest in the sport. I have my comeback rehearsed. What about swimming? A nice, soft, relatively injury-free sport, I'd say. Table tennis? Or chess, perhaps?

So when I hear the governor on the radio saying how he's concerned about accepting the Medicaid expansion included in the Affordable Care Act, it is frustrating. Gov. Parnell said he has concerns that the Affordable Care Act would expand the Medicaid program significantly with no guarantee that funding for that expansion would continue from the feds. He cited the federal government's precarious financial position. Other governors have approached this issue of un-guaranteed future funding by putting in clauses that would allow those states to retract the expansion if federal funds supporting the program are cut. But Parnell offered no such compromise. While he hasn't outwardly stated he's going to opt out of the program, his politics certainly lean in that direction.

That's bad news, no matter if you already have medical insurance or not, because it is a loss to the state as a whole. A report released this month by Northern Economics commissioned by Alaska Native Tribal Health Consortium said the preliminary estimates for the Medicaid program would bring a significant amount of money to the state. For every dollar the state spends related to Medicaid expansion, $15.50 in new federal funds will be generated. The report estimates between 2014 and 2019, the state will spend $56.3 million for new enrollments, and would in turn receive $873.2 million in federal funds. The report identifies other savings to the state because of the program. It also notes that the Medicaid expansion would create an additional 4,000 jobs by 2017 in Alaska, with $230 million in additional annual labor income by 2019.

The implications for Alaska reach beyond that, too. Tribal health organizations would also get a boost, allowing them to use their funds to do significantly more for the populations they serve.

The federal funding for this expansion would continue at 100 percent for the first year of the program starting in 2014 and decline to 90 percent by 2020. I found it interesting that this expansion of the Medicaid program still only serves those just barely making ends meet. The eligibility level, which would rise to 138 percent of the federal poverty level, would cut off around $20,000 for an individual and $26,000 for a couple. If you live in Alaska on $20,000 a year, you eat a lot of Ramen noodles and have your thermostat set on "shiver." So we are not exactly talking about a free ride here. We are talking about providing health care for those who would absolutely have to go without and suffer because they did not have the money to pay for even the most basic health care.

I'm sure there are a lot of arguments in favor for and against Obamacare. I'm sure there are parts of it that would come as a shock to me. I'm a little worried about what it will mean to insure myself in less than a year -- will affordable insurance really materialize in time? But the reality is this: It's a crushing situation to feel the fear of facing a serious medical problem and an even more serious financial problem simultaneously. This program would remove that unbearable situation for thousands of Alaskans, reduce it for thousands of others, and infuse money into the state at the same time.

Concern about potential future what-ifs of federal funding should not play a part in the state's decision to accept or reject the Medicaid expansion. Alaskans need expansion -- and more -- right now.

Carey Restino is the editor of The Bristol Bay Times, where this commentary first appeared.

Alaska Dispatch encourages a diversity of opinion and community perspectives. The opinions expressed herein are those of the contributor and are not necessarily endorsed or condoned by Alaska Dispatch. To submit a commentary for consideration, e-mail commentary(at)alaskadispatch.com.