An Alaska Policy Forum op-ed on Feb. 12 derided the decision to expand state Medicaid during the Walker administration, citing the moral dangers of extending health care coverage to “able-bodied” Alaskans. The Alaska Policy Forum supports this position by referring to a 2018 study by a Florida conservative advocacy group that claims 55 percent of U.S. Medicaid expansion recipients don’t work. The Florida study is grossly incomplete, generalizing its conclusions based on information from from only 11 of the 31 states that expanded Medicaid.
Traditional Medicaid covers Alaskans with annual family incomes up to $26,000 for a family of three. The Alaska Medicaid expansion extended coverage for working families of three with incomes from $26,000 - $36,000. By definition, those newly covered by Medicaid expansion are the “working poor” in order to satisfy the income requirements. Traditional Medicaid coverage was also extended to poor adults not legally classified as disabled, and many of these adults are not able to work. Research done by the Institute for Circumpolar Health at UAA in 2011 shows low-income Alaskans who don’t work disproportionately suffer from cognitive, mental and physical impairments and low educational levels affecting their earning potential.
The term “able-bodied” has become a nationally politicized term to convey the inaccurate message that people are “poor” because they are unmotivated to work and therefore undeserving of assistance. The Alaska Policy Forum claims their Florida study “debunks” extensive research by the non-partisan Kaiser Family Foundation that reviewed Medicaid data from all 50 states and found the majority of Medicaid recipients in the U.S. are already in working families.
The Alaska Policy Forum is trying to market the idea that poor Alaskans are able-bodied and that simply requiring them to work will make them self-sufficient. This oversimplified concept could not be further from the truth. Setting up additional structures to monitor and confirm work status would be costly and increase state bureaucracy.
The Alaska Policy Foundation decried the high per-person costs as a reason to oppose Alaska’s Medicaid expansion, implying that Alaskans in this income range should be able to afford their own health care, despite the fact that health insurance in Alaska could consume well over half of that family’s income. On the contrary, that financial burden would not pave the road to self-sufficiency for these families.
Next time, the Alaska Policy Forum should do its homework before it presents the “truth” to Alaskans.
John Riley, PA-C, M.S., is a retired member of the University of Alaska Anchorage Health Sciences faculty.
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