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Gov. Bill Walker: Medicaid expansion is the right thing to do

This week, I introduced legislation to provide health care to more Alaskans using less state money. My bill calls for using all available federal resources and reforming the state's Medicaid program to improve the lives of Alaskans.

One of the perks of my job as governor is health insurance. For those of us who have insurance, it's easy to forget what it's like for the thousands of Alaskans who do not.

They are one mishap away from financial ruin. Medical debt is now the top cause of personal bankruptcy filings in the U.S. No one should have to choose between life-saving care and losing their home.

The federal government is extending Medicaid coverage to help those who don't earn enough to buy health insurance. Alaskans who make $20,314 a year ($9.60 an hour) or less, or married couples who earn a combined $27,490 a year or less will qualify.

Medicaid coverage will enable Alaskans to get the care they need to join or stay in the workforce. It will help those coming out of prison get substance abuse treatment and stay out of trouble. It will reduce medical costs for all of us by reducing the amount of care hospitals provide that no one pays for. And it will pump millions of federal dollars into Alaska's economy at a time when we can surely use it.

Through 2016, the federal government will pay 100 percent of the costs of those newly eligible. After that, the federal share transitions to 90 percent in 2020.

Some say the 10 percent state match is too much. I disagree. That's the same match we pay for federal highway and aviation dollars. If this were money for a transportation project, we'd be doing backflips. Why should Alaskans' health and well-being be less important than our roads and airports? Why are doctors and nurses less valuable than road crews?

The state will generate savings by using federal Medicaid dollars to pay for services we now pay entirely with state money. With these savings, we will be able to pay our 10 percent match and still save money.

Some say we shouldn't accept this federal money because it contributes to the national deficit. I disagree. We don't turn down federal money for education, transportation and the military, and we shouldn't turn it down for health care. Alaskans pay into the federal treasury and we ought to claim every dollar we're due.

Some say the federal government might demand more than the 10 percent match. My bill makes Alaska's participation contingent on the federal government maintaining its legal match. I've received written confirmation from federal authorities that we are free to withdraw if the federal government reduces its match.

My bill also calls for smart, Alaska-based reforms to ensure we can afford Medicaid over the long term. For example, we are applying for three federal waivers. These waivers will allow us to save money by tailoring our program to Alaska's particular needs and circumstances.

We've already started reforms. My budget calls for $20 million in Medicaid reductions through efficiencies and tightening program rules.

Twenty-eight states have accepted additional federal Medicaid money. They are seeing results. Kentucky saved $9 million in the first year. Arkansas saved $17.5 million. In Arizona, uncompensated care fell by 30 percent in the first year.

I want Alaska to share in these benefits. That's why I included the federal Medicaid money in my proposed budget. House lawmakers removed that money from the budget and asked that I introduce a stand-alone bill.

I've now done that, and now I need your support. Alaskans who need health insurance are counting on us to act. We already missed the first year of 100 percent federal match, and I don't want to lose another year.

At my inauguration, my pastor reminded Lt. Gov. Byron Mallott and me of our duty to those who are less fortunate. I never want to forget that responsibility.

As Alaskans, we have a long tradition of caring for each other when times are tough. I urge you to tell your legislators you care. My administration's Medicaid proposal will save money and save lives. It's the right thing to do.

Gov. Bill Walker is a lifelong Alaskan. He was elected governor as an independent in 2014 and currently lives in Juneau with his wife, Donna.

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.

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