Governor: Medicaid reform without expansion unacceptable

  • By Becky Bohrer
  • Monday, April 13, 2015 10:41pm
  • News

JUNEAU — Gov. Bill Walker said Monday that he could not support Medicaid reform legislation without Medicaid expansion.

In an interview with The Associated Press, Walker said reform and expansion go hand-in-hand. To have reform and not expansion, he said, would be unacceptable.

“I’m expecting to see that it gets through,” he said of Medicaid expansion. “That’s my belief that that needs to get done.”

Supporters of Medicaid expansion say it helps leverage federal resources to pay for reform efforts. In states choosing expansion, the federal government is to pay 100 percent of health care costs for newly eligible recipients through 2016, stepping down to 90 percent by 2020.

But some Alaska legislators worry about adding more people to a system they see as broken. Medicaid, as it stands, is widely seen as unsustainable.

Committees in the House and Senate on Monday heard reform-only bills aimed at trying to reduce and contain costs within the existing Medicaid program. The House Finance Committee on Saturday introduced reform legislation similar to bills pending in the Senate from Sen. Pete Kelly, R-Fairbanks.

House Finance Committee co-chair Rep. Steve Thompson, R-Fairbanks, said members have said they want to see changes made to the Medicaid program before they feel comfortable with passing expansion. The new bill is intended to get that discussion started, he said.

The Legislature is scheduled to adjourn on Sunday. Following a hearing on his bill Monday morning, Kelly — who has said he doesn’t think he can support expansion — said his desire is to have a reform bill that is well-vetted and makes sense.

“Honestly, on this and other things, we’ve got some pretty big problems in the state right now and we have this artificial barrier,” he said. “And if we have to go longer to do the right thing, then that’s fine with me.”

Last week, the House Finance Committee heard from health care industry representatives that while they are interested in pursuing reforms, funding is a concern. Health commissioner Valerie Davidson has said that, based on the experiences of other states, expanding Medicaid coverage could mean that hospitals would see reduced levels of uncompensated care. The hospitals could then use the savings to support changes to how they provide health care, Davidson said.

Walker would not say under what conditions he might feel the need to call a special session. “But my must-haves are must-haves,” he said. Those are Medicaid expansion, legislation surrounding an energy project for Interior Alaska and a “budget that works.”

On the budget, he said he’s concerned about proposed cuts to education and the state ferry system, as well as a proposal to reject monetary terms for next year in contracts for more than a dozen unions.

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