State Mulling Medicaid Expansion

Last week Health and Human Services Secretary Kathleen Sebelius extended the deadline for states to decide whether to establish a healthcare exchange or have the federal government design and run it for them.

Governor Sean Parnell said in July, and reiterated last week, the state will not run its own exchange, which supporters liken to websites that compare and sell airline tickets. Many governors across the country are vetoing the local control of the exchanges and also refusing to expand Medicaid.

Governor Parnell commissioned the Lewin Group to study the cost of the expansion. The findings are due out early next month.

U.S. Senator Mark Begich said people will pay more if the state doesn’t expand the roles.

“We have to carry the burden for the 32,000 folks who don’t have coverage,” he said in  a Tuesday phone interview. “Because when those 32,000 get sick, they still get coverage, they walk into the emergency room when they should have gotten preventive care. When they walk into the emergency room – that bill they don’t pay, the hospital shares that cost with everyone else who is insured.”

The 32,000  figure is a good estimate of people who could possibly be added to Medicaid, said Josh Applebee, who works on health care policy for the state. But it’s a number that could be refined in the study.

Applebee said the Supreme Court ruling gives the state latitude: Governor Parnell can choose to expand the roles January first 2014, or later, or not at all.

The Medicaid expansion was a key element to the healthcare law; it would have opened roles to Alaskans making up to$18,500 a year. Alaska has its own federal poverty line.

Applebee said it’s unclear whether the state will be able to set its own guidelines for new Medicaid recipients.

“The federal government and the Centers for Medicaid and Medicare Services has not made a decision on whether they’re going to be flexible in the types of expansion they’ll allow states to do,” he said.

In the past, Governor Parnell has said he’s unlikely to expand Medicaid. The governor would not comment for this story, but his office issued a statement saying the state is moving cautiously. It pointed out that there is no federal deadline for the Medicaid expansion, so just because the report is due next month, does not mean there will be a decision.

Supporters contend there’s an incentive to act quickly: The federal government will pay 100% of the Medicaid expansion for years 2014, 2015 and 2016.