Voices of Alaska: Buyer beware on Medicaid expansion

  • By Suzanne Downing
  • Wednesday, July 15, 2015 5:47pm
  • Opinion

The Medicaid expansion described by Rep. Les Gara in his recent op-ed is a mythical creature that exists only in his dreams.

To summarize the Anchorage representative: Medicaid expansion is free and won’t cost Alaska a dime. It will magically grow 4,000 jobs. How many of these jobs will be healthcare jobs, and how many will be paper-pushers, he doesn’t say.

Like U.S. Rep. Nancy Pelosi, Gara wants the governor to just sign the Affordable Care Act’s Medicaid expansion paperwork, so we can find out what’s in it. On planet Gara, it’s a no-brainer.

But I hope that Alaskans do use their brains when considering expansion of the Medicaid system, not just here, but across the country. The inefficiencies and bureaucratic bloat is costing our state dearly, sucking up one-third of the state’s current budget.

Gov. Bill Walker, with his expansionist plans, is introducing Greek economics into Alaska, where we keep running up the tab with big government, and not nearly enough revenue to pay for it in the long run. This is the same governor who has refused to give the Legislature a 10-year revenue forecast, as required by statute, but keeps piling on the payables.

A big part of his unknown revenue stream will underwrite Alaska’s Medicaid follies. This winter it became known that a top Department of Health and Social Services director, under oath, said the state paid $165 million in advances to healthcare providers who never performed the work. The state managed to recover $60.4 million, but will likely never see the outstanding balance of $104 million. Those providers are long gone. The director enumerated a long list of other horribles in the Medicaid billing system.

As for the legitimate doctors, nurses, and medical facilities in Alaska, they are getting squeezed. Earlier this month the Walker Administration refused to give them their Medicaid cost-of- living increases. Medical providers already only get paid just 78 percent of the care they give Medicaid patients, and with the governor cutting their pay, their incentive to accept Medicaid clients will evaporate.

The real Medicaid program, not the one conjured up by Obamacare marketing, is has a cost cap of “infinity,” and is growing so fast that by 2030 it will become a $4.5 billion chunk of Alaska’s annual operating budget. In other words, by the time today’s newborn is in high school, Medicaid in Alaska will cost as much as nearly all of state government does today.

You’d think our state would learn from the Ohio experience: The projected expansion was estimated at $2.56 billion, but the actual costs are already well over $4 billion. Ohio’s projected expansion enrollment was 366,000, while the actual enrollment has already topped 600,000.

This week, Walker appears ready to forge ahead and expand Medicaid with his “Redesign and Expansion” project launch. He’ll add 40,000 able-bodied, childless adults into the big government medical establishment he is building, as he does his part to advance President Obama’s vision to “fundamentally transform America.”

Alaska, known for our self-reliance, will have one third of our people will be fully dependent on the government for their medical care.

The transformation will be that Alaska doctors opt out in greater numbers than ever and older Medicare patients, whose care is reimbursed at a much lower rate, will go without care until they are forced to head for the nearest emergency room or leave Alaska altogether.

To be clear, while Alaska’s elders will be hurt, Medicaid expansion will benefit the Native population because health service utilization gets 100 percent match.

It’s everyone’s hope that “Big Government Bill” Walker’s risky play will work out, but the data is rolling in from across the country that shows quite an unhappy picture for many Medicaid recipients.

Recently, a U.S. Department of Health and Human Services study found that among 1,800 Medicaid health providers sampled, more than half were not offering appointments to enrollees.

For those providers who would make appointments for enrollees, the wait times were long — more than one quarter of enrollees had to wait for a month to see a doctor. This is defacto health care rationing for the poor.

A New England Journal of Medicine study in Oregon is perhaps the biggest harbinger of what we can expect to see in Alaska: Sadly, Medicaid expansion brought no significant measureable health outcomes. In fact, people who had no health insurance were in better health than Medicaid enrollees.

I’m reminded that ObamaCare architect Jonathan Gruber was embarrassed when audio of him stating Obamacare passed because of “the stupidity of the American voter” was posted online for the world to hear. Medicaid expansionists are counting on the same thing.

My caution is, “Buyer beware.” Our gullible governor is on the verge of expanding Gara’s mythical creature — a Chimera.

Suzanne Downing is communication director for the Alaska Republican Party.

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