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When you do the homework, Medicaid expansion makes sense for Alaska

  • Author: Bob Williams
  • Updated: July 8, 2016
  • Published April 27, 2015

As a guest on the Glen Biegel show during my campaign for lieutenant governor, I was surprised by the certainty and conviction of callers that described Medicaid expansion as "welfare" and thought that improving health care for 40,000 Alaskans was somehow "taking away their dignity." My dad's top logging salary was $26,000 a year and he spent a considerable sum of money on catastrophic high-deductible insurance. Health care shouldn't be treated as a luxury item that is not deserved by Alaskans that work hard but don't make a lot of money. We will actually be honoring the dignity of our neighbors when we improve the quality of life and the health of 40,000 Alaskans.

The Legislature in 2014 gave a $10 million-per-year tax credit to the Tesoro refinery even though the refinery was profitable and hadn't asked for it. The reasoning was that refineries needed help to be competitive and legislators did "not want to pick winners and losers." A state that can assist profitable refineries can afford to assist Alaskans that need health care security. If our Legislature passes Medicaid expansion, Alaska will be more competitive and will decrease the likelihood that Alaskans will be winners or losers based solely on their medical luck or misfortune.

Gov. Bill Walker has requested our Legislature seriously study Medicaid expansion. As a practicing classroom teacher, I know that resistance to homework is common but 40,000 Alaskans deserve the effort and deeper consideration of our governor's homework request. A serious analysis can lead to better decisions based on reason, logic and evidence.

A 2012 Sommers peer-reviewed study in the New England Journal of Medicine compared health outcomes in Arizona, New York and Maine, which had expanded Medicaid in the early 2000s. The study found comparing the five years before and after Medicaid expansion resulted in a statistically significant decrease in the death rate, with the largest impacts on the elderly, the poor and non-whites. The number of people that delayed health care due to costs also declined and the number of people that described their health status as good or excellent increased. Which one of these results do we not want to see in Alaska?

Medicaid expansion also brings the opportunity to diagnose and treat illnesses early before quality of life significantly decreases and treatment becomes much more expensive. A just-released March 2015 study by Quest Diagnostics found a 23 percent increase in newly diagnosed diabetes in Medicaid expansion states and a negligible 0.4 percent increase in states that didn't expand Medicaid. Why isn't Alaska on the side of early treatment and prevention for an expensive and potentially devastating disease that has a U.S. price tag of $175 billion a year?

Alaska's previous commissioner of Health and Social Services, Bill Streur, said in 2013 that he wasn't sure if more health care might end up killing more people. The 2012 Sommers Medicaid expansion study clears up any confusion. The study showed that for every additional 176 people that were insured by Medicaid expansion, about one extra life was saved per year. With 40,000 Alaskans eligible for expansion, that would mean saving more than 200 Alaska lives a year. Even if Alaska's rate was less, the number of Alaskans we would be saving might fill an Alaska Airlines 737 every year.

These tremendous benefits from Medicaid expansion are not free. Like building highways and roads, the financial burden to Alaska would be enormous if we had to pay for 100 percent of the costs. The great thing about Medicaid expansion is that it is quite similar to improving or constructing our highways; the federal government gives us a 90 percent-off coupon and makes the price not just reasonable but a real bargain.

Medicaid expansion will also help our economy. A recent headline noted ConocoPhillips was going to cut around 25 jobs. Medicaid expansion will create 4,000 additional jobs in Alaska and over time more than a billion dollars that will flow through our economy. Under these terms, Alaska can afford to take care of its own people and improve their quality of life in a way that aligns well with our financial, moral and ethical values.

I often think of the hostility toward those that would benefit from Medicaid expansion. It's easy to mischaracterize these Alaskans when we don't physically see them. Let's do the homework the Legislature has been unwilling to do and put this in perspective. Let's physically count the next 200 people we see at school, the grocery store or a sporting event, whether we live in Anchorage, Fairbanks, Juneau, Mat-Su or a village. Let's look at the beauty and imperfections of each of the 200 faces and then ask ourselves if we're willing to pay 10 cents on the dollar to save all of their lives. It's time to put Alaskans first and expand Medicaid.

Bob Williams is a Mat-Su educator, a 2009 Alaska Teacher of the Year and a candidate for lieutenant governor in 2014.

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)

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