Community health centers are the backbone of Alaska health care. Medicaid expansion rollback threatens us.

We are neighbors helping neighbors. We put a premium on community. We are Alaskans.

Last week, I was privileged to witness a group of passionate, committed medical professionals provide feedback to the governor and Department of Health and Social Services leadership. I was struck by their eloquence in articulating their passion for their patients and why the Medicaid program – especially Medicaid expansion – has been so critical for Alaska. Doctors stood up for their patients who lack adequate coverage to receive preventive care and end up in the emergency department with advanced, life-threatening disease. Alaskans are lucky to have such outspoken advocates for their patients and the programs that support healthy people and a healthy economy.

I’m personally fortunate to work with a specific group of medical providers in our network of 27 Community Health Centers, or CHCs, that deliver care to more than 113,000 Alaskans every year. CHCs are nonprofit organizations that deliver primary and preventive care to everyone in the community – even medically under-served and uninsured people. Nearly all CHC patients have incomes under 200% of the Alaska poverty level, about $30,000 for a household of one annually, and about 25% of them are covered by Medicaid. Because of this, health centers have a unique relationship with Medicaid – the program must pay for all CHC required services. In exchange, however, CHCs are held accountable for their outcomes.

Because CHCs provide a full array of community coordinated health services, such as medical, dental, vision and behavioral health, Medicaid patients seen in CHCs have 24% lower costs to the health care system, which drives down the cost of health care for the state and private insurers. At the same time, CHCs are mandated to improve the health status of the entire community in addition to the health of individual clients; provide services that are accessible to their target population while coordinating with other community services; and include community members in program planning and organizational governance. This results in healthier, sustainable communities that allows for individuals to work, support their families and be productive members of their communities.

Health Centers are indispensable lifelines for Alaska – they truly serve as a safety net. But if Medicaid expansion is rolled back, there will be a cascade of events that will threaten the strength of this network. If it’s repealed, 49,000 Alaskans will revert to being uninsured. CHCs will continue to serve the health care needs of that population – but these non-profit organizations will weaken and suffer under the weight of charity care. And, although CHCs are there for primary care, when a patient without insurance gets a serious diagnosis, she will not find a specialist to see her. The disease will progress to the point of urgency, and she will land in the emergency department, generating thousands of dollars in medical debt she cannot pay, requiring the CHCs, the state and private insurers to foot the bill.

If we are not neighbors helping neighbors getting adequate health care, we will end up being neighbors who share the downstream costs of preventable and expensive emergency department visits.

This is exactly why APCA and more than 25 additional organizations from across the state have joined together to organize Alaskans Together for Medicaid, a nonpartisan, statewide coalition focused on improving Alaska’s Medicaid program.

Join us in amplifying our efforts, ensuring that health care for the most vulnerable is not stripped away by budget cuts or program restructuring. Visit us at alaskanstogetherformedicaid.org to take action in protecting Medicaid.

Nancy Merriman is the Executive Director of the Alaska Primary Care Association and a proud member of the Alaskans Together for Medicaid coalition.

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