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Medicaid expansion proves good for Alaska

  • Author: Chris Ashenbrenner
  • Updated: December 8, 2016
  • Published December 8, 2016

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It's not often that government has a chance to help thousands of people and save money at the same time. Medicaid expansion was one of these opportunities.

Expansion is a bright spot in a dismal Alaska economy. Over 25,000 people now have health coverage at no cost to the state of Alaska. Alaska health care providers have received over $288 million in revenues since it started in September 2015.

Health care jobs are the fastest growing sector in our economy, in part due to Medicaid expansion.

Expansion saved the state money. Grants were reduced to mental health providers as people began getting the new coverage. The 100 percent state-funded Chronic and Acute Medical Assistance program is nearly zeroed out. It was formerly budgeted at $1.5 million a year — all state funds.

Over a hundred inmates' hospitalization costs were shifted from 100 percent state funds to all federal funds this last year. This should continue to grow as inmates age and need more intensive health care. Plus, as they exit the prison system many will be eligible for Medicaid coverage that would not be available without expansion. It's in all our best interest to see those who need physical or behavioral health services get treatment and improve their ability to work, be productive and stay out of prison.

Just these savings should be $13.3 million in fiscal year 2017. That far exceeds what the state has to chip in for the coverage which is 5 percent starting Jan. 1, 2017. Even if the expenditures this year were 50 percent higher than last year, which is very unlikely, we still save general funds.

Our hospitals should soon be seeing significant reductions in their charity, or uncompensated, care. Other states, like Montana and Ohio, report their hospital charity care decreased significantly. This will especially help our many small critical care community hospitals that sometimes struggle to stay afloat.

But there's more. As Gov. Bill Walker worked with the federal government to implement expansion, he strongly advocated for changes to the way they reimburse for tribal members who receive Medicaid. The federal government listened and made a change to their policy resulting in even more Alaska general fund savings — projected to be over $30 million this year and growing each year.  By 2022, it's estimated to be over $90 million. This would not have happened without expansion.

There is much conjecture right now about the Affordable Care Act going away.  We don't know what the new landscape may look like but most experts agree that it will take at least two years to repeal and hopefully replace it with something that does not leave 20 million Americans without coverage and collapse the health insurance market.

Meanwhile, let's focus on the benefits to Alaska's economy and remember that there are compelling human health reasons to have health coverage. People are diagnosed earlier with diabetes and other controllable diseases. They can get treatment for conditions that keep them from working like my friend who was finally able to get medicine for a chronic illness and now has a good job with health insurance. Or the 40-year-old woman who did not have health insurance and got diagnosed with cancer. She got treatment and is now in remission so she can go on taking care of an elderly couple. There are thousands more such stories.

These economic and human outcomes are invaluable — both for the individuals and for us as a society.

Chris Ashenbrenner spent her career in public and nonprofit service advocating for social justice. She is now retired after working for the Alaska Department of Health and Social services to help implement Medicaid expansion.

The views expressed here are the writer's and are not necessarily endorsed by Alaska Dispatch News, which welcomes a broad range of viewpoints. To submit a piece for consideration, email to commentary@alaskadispatch.com. Send submissions shorter than 200 words to letters@alaskadispatch.com

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