Watching the Alaska House of Representatives debate the state operating budget Thursday night, there was no mistaking the fact that the state is facing a financial crunch. Nearly every discussion focused on what the state could afford. But that all changed when the body had the chance to accept an expansion of Medicaid in the state that would extend health coverage to as many as 40,000 Alaskans. Despite the fact the expansion would be a massive infusion of federal funds for the state, would help tens of thousands of state residents struggling to make ends meet and is estimated to generate $6.6 million in state, legislators descended into partisan rhetoric and a vote providing for expansion failed on party lines. That’s a disservice to Alaskans.
The Affordable Care Act health care reform of 2010 greatly expanded medical coverage options for Americans through a system of government subsidies for health insurance. But part of the act was left up to individual states: To cover those in the gap between current Medicaid service and the income level at which subsidies were available, the ACA would expand Medicaid to cover those just above the poverty level. To make the expansion amenable to states that might be skeptical about the move, the federal government pledged to fund 100 percent of the expansion cost through 2016, then transition to 90 percent in perpetuity afterward.
Unfortunately, state legislators’ willingness to accept all manner of federal funds in other arenas apparently does not extend to health care. Citing fears (so far entirely unfounded) that the federal government might someday shift more than 10 percent of the cost to states, Alaska’s leaders and those of nearly two dozen other states declined to participate in expansion. During the past year, as fears about increased cost burdens have not been realized, several of those states are moving in the direction of accepting expansion — states such as Montana, Idaho, Utah, Missouri and Florida, among others.
Alaska, by contrast, isn’t budging, and as time goes on, legislators’ opposition to Medicaid expansion here appears more and more to be motivated by partisanship rather than genuine concern over the financial aspect of the change. On the House floor Thursday afternoon, Rep. Shelley Hughes (R-Palmer) said she opposed the expansion because she thought it wouldn’t encourage people to improve their economic status.
“I think that a caring person wants to see someone improve their lives and get out of that bracket,” she said.
The notion that Alaskans would be rendered lazy and unmotivated by health insurance doesn’t hold water — it’s offensive to the character of our state’s residents and particularly so to those who currently have no economic health care options.
Others within the majority caucus in the Legislature have stated they would rather address the issue in a standalone bill rather than the operating budget. That seemed plausible until members of the minority pointed out that they have submitted such bills in this legislative session and previous ones, none of which have seen serious consideration by the body. Then majority members suggested the bill needed to come from Gov. Bill Walker’s office instead. The governor did campaign successfully on the issue of accepting Medicaid expansion, but the quibble over the pedigree of the bill is a smokescreen majority members are disingenuous to employ.
The underlying facts make a strong case for accepting the expansion of Medicaid: Tens of thousands of economically at-risk Alaskans would receive health coverage that residents are already paying for through federal income tax. If the federal government scaled back their funding of the expansion below 90 percent, the state could terminate its participation automatically.
Alaska has never been shy about accepting services its residents pay taxes for. A year when the state is facing a $3.5 billion budget deficit would be a spectacularly poor time to start.
— Fairbanks Daily News-Miner,
March 15
