A group of Alaska doctors, with help from a union-backed organization in Washington, D.C., is proposing a pair of ballot initiatives to establish state-level health insurance requirements like those in the federal Affordable Care Act.
With the Affordable Care Act — also known as "Obamacare" — under attack by President Donald Trump and congressional Republicans, one of the initiatives would enshrine many of the federal legislation's most popular provisions into state law.
The 11-page proposal would bar insurers from denying coverage based on pre-existing conditions, require family plans to cover children until they turn 26 and ensure that all plans offer 10 different "essential health benefits" like prescription drugs, emergency services and mental health care.
The second initiative aims to bolster the Medicaid health care program for the low-income and disabled Alaskans that Gov. Bill Walker expanded under "Obamacare." The expansion covered an additional 35,000 Alaskans.
That two-page measure would set health care providers' Medicaid payment rates, which have been eroding, at no less than they were Jan. 1. And it would bar the state from making its Medicaid eligibility standards tighter than they were at the start of the year — meaning that Alaskans who got health care under the expanded program could keep it even if Congress makes federal benefits more difficult to obtain.
Currently, no state-level law specifically authorizes the expanded Medicaid program. After the Legislature rejected such legislation, Gov. Bill Walker expanded the program in 2015 using his executive powers in a move that survived a court challenge from Republican lawmakers.
The four doctors — Alec Glass, George Rhyneer and Megan LeMasters Soule of Anchorage and Alan Gross of Petersburg — filed the two initiative applications earlier this month with the state Division of Elections, which is now reviewing them.
If approved, the initiative backers would have until mid-January to gather more than 30,000 petition signatures from across the state — if the questions are to appear on the 2018 ballot. Before that can happen, state attorneys working with the elections division will have to rule that the proposals don't violate constitutional restrictions on initiatives, which include a ban on measures that make appropriations.
Glass, a neurologist who's co-sponsoring the Medicaid initiative but not the insurance proposal, said he was recruited to the effort by Anchorage political consultant Jim Lottsfeldt. The Medicaid measure aligns with Glass' own ideas about the health care system by giving more Alaskans access to insurance, he said, and it could potentially drive down costs in the individual market by moving some sicker people to government-funded insurance.
“I think this covers more people and takes care of a larger segment of our vulnerable population,” Glass said.
Lottsfeldt declined to comment and the other doctors couldn't be reached Tuesday: Rhyneer didn't respond to requests for comment, LeMasters Soule was out of the office and a phone number for Gross that initiative supporters gave to state campaign finance regulators led to a Juneau clinic where he no longer works.
Filings with the Alaska Public Offices Commission suggest that the doctors and their allies are mounting a well-funded campaign.
A pair of political groups chaired by Gross disclosed more than $300,000 together in payments and debts incurred in July and August, according to the filings.
The groups — "Defend Alaska's Care" and "Healthcare for Alaska" — reported $30,000 in debt to a firm run by Lottsfeldt.
The groups also reported a combination of $320,000 in payments and debts to Scott Kohlhaas, who runs a signature-gathering business.
While the initiatives' subject is "fairly easy," Kohlhaas said in a phone interview, the supporters will have a "tough fight" to gather the necessary signatures before their January deadline.
"We're facing a winter drive on both of them," he said.
Nearly all of the two political groups' income — a total of $50,000 — comes from The Fairness Project. That group, based in Washington, D.C., was originally created with seed money from a California hospital workers labor group — a branch of the Service Employees International Union — and it campaigned for minimum wage hikes in several states in the 2016 elections.
Officials at The Fairness Project didn't respond to a request for comment Tuesday.
Health care and insurance industry representatives said they were just learning about the initiative and weren't involved in drafting it.
"These just got dropped, so we haven't had a chance to go through and digest them," said Jim Grazko, president of Premera Blue Cross Blue Shield of Alaska, the only company still selling health plans on Alaska's individual insurance marketplace, part of the Affordable Care Act.
Grazko said he expects the initiatives' impact would be minimal unless Congress changes federal insurance laws.
"It looks like we'd be kind of neutral on it at this point," he said.
State regulators declined to comment on the proposals, with Lori Wing-Heier, the director of the Alaska Division of Insurance, writing in an email that they're still being reviewed.