JUNEAU — Legislators, aides and others heard an alternate viewpoint on Medicaid expansion Wednesday from a senior fellow with an organization that has referred to the “dangers” expansion poses in states that opt for it.
Christie Herrera, with the Foundation for Government Accountability, spoke to problems she said some states have experienced, including enrollment numbers that far exceeded projections. Herrera spoke during an informal “lunch and learn,” sponsored by Sen. Mike Dunleavy and put on by Americans for Prosperity-Alaska. The group is part of the national Americans for Prosperity organization and opposes Medicaid expansion.
Dunleavy, R-Wasilla, said earlier this week that he is still trying to understand what expansion is all about — what it could look like and what it might mean — and believes getting as much information as possible on the issue benefits everybody. At least 14 legislators — Republicans and Democrats — attended at least part of the event, which was crowded. She was challenged on some points by Democratic lawmakers and the president of the Alaska State Hospital and Nursing Home Association, who support expansion.
While state health Commissioner Valerie Davidson has given presentations on expansion during various legislative hearings, those meetings were focused on hearing from the administration and were not open to testimony from challenging or opposing viewpoints. The House has not taken up a bill calling for expansion from minority Democrats.
Davidson, who also attended Wednesday, questioned Herrera’s use of data in Arizona and Maine showing experiences those states had in expanding Medicaid on their own before the federal health care law under which Alaska is considering expanding coverage. One difference between expansion before the law and after, Davidson said later, is the federal match rate.
Herrera said those states, billed as cautionary tales, provide a longer-term view of data and are relevant because they included the same population as those who are eligible for expansion under the health care law.
Herrera also said some states did not get the flexibility that their governors had wanted in expanding coverage. Davidson told reporters later that it’s hard to have sympathy for a state that didn’t negotiate well with the federal Centers for Medicare and Medicaid Services.
One concern raised by some Republican legislators has been what happens if the federal government’s match rate falls below 90 percent, the lowest level to which it is supposed to fall for the newly eligible expansion population. Davidson said the state has told the federal government it will not participate in expansion if the contribution falls below 90 percent. Asked if there were any strings attached to that, such as having to find another way to provide coverage to people who fell within the expansion population, she said no.
Walker made expansion a priority, but he has butted heads with members of the House, who have called for him to introduce a bill of his own dealing with expansion rather than deal with it as a budget item. The House Finance Committee has stripped items related to expansion from its draft of the operating budget.
Walker spokeswoman Grace Jang has said the administration is working with the Senate. She said Walker is planning town-hall meetings to tout the benefits of expansion and rally support as lawmakers consider it.