Senators skeptical of Medicaid expansion decided to hire the Parnell administration's top health official because they wanted his advice on Medicaid and other issues, the co-chairman of the Senate Finance Committee said Thursday.
In discussing the Senate Finance Committee's contract with former Health and Social Services Commissioner Bill Streur, Sen. Pete Kelly, R-Fairbanks, predicted the state has "no choice" but to cut spending on Medicaid.
Kelly said the contract of up to $45,000 with Streur makes sense because of his knowledge of health care administration, including Medicaid. During his years as commissioner, Streur held Medicaid increases to a far lower level "than we ever dreamed were possible," Kelly said Thursday.
When then-Gov. Sean Parnell decided to not expand Medicaid under the Affordable Care Act to cover low-income adults without children, he directed Streur to study the issue. In October, when then-candidate Bill Walker said Medicaid expansion would be his first act if he was elected governor, Streur said Walker was misrepresenting the cost to the state.
"Bill Walker keeps talking about how it's all free, but it's not," Streur said.
Streur's knowledge led the Finance Committee to hire him, Kelly said.
"It is for that reason that we are tapping him for his experience and insight into this budget, so that as we go forward, we have to cut Medicaid, we don't have a choice, I don't think. But we have to do it with a high level of sensitivity and with the expertise that can justify what we've done," Kelly said. "We have to be able to look Alaskans in the face who need this stuff and say, 'This is why we had to do it and this is why we did it the way we did it.'"
Some estimates say as many as 40,000 uninsured Alaskans would benefit from Medicaid expansion, with the federal government picking up nearly all the costs.
"Many in the faith-based community, the Alaska State Chamber of Commerce and other job creators say Medicaid expansion isn't just good for the health of our citizens, it's good for the health of our economy," Walker said Wednesday in his State of the State speech. "It is estimated this could create as many as 4,000 new medical jobs in Alaska."
Kelly opposes Medicaid expansion.
"We're not headed for a Medicaid expansion. Actually right now if you had to ask me, I'd vote no," Kelly said, adding that he is open to changing his mind if Streur provides evidence that Medicaid should be expanded. "If I'm wrong, I need to know it and I'm perfectly willing to reverse myself," Kelly added.
Eagle River Republican Sen. Anna MacKinnon said the committee would ask Streur to see if there are ways to save money with Medicaid expansion. "We are absolutely going to take very seriously Gov. Walker's desire to expand Medicaid from a finance position," she said.
Bethel Sen. Lyman Hoffman, a Democrat who caucuses with Senate Republicans, said he wanted to make it clear that hiring Streur was not designed to produce a report to fight Medicaid expansion.
"I wanted it on the record that the purpose of hiring Mr. Streur and this contract is not specifically to find ways to give us justification not to expand" Medicaid, said Hoffman.
"That's correct," said Kelly.
Streur served as commissioner under Parnell when Parnell rejected the federal plan in 2013 to extend coverage to more low-income people in Alaska.
The committee also voted to approve the hire of former Parnell administration Revenue Commissioner Angela Rodell as a consultant for about $900 a day to look for ways to save money in the complicated state budget on such matters as investment strategy, retirement funds, the Alaska liquefied natural gas project and other topics. The total contract is for $80,700, with an additional authorization of up to $19,000 in case the Legislature goes beyond its normal session.