Walker Announces Plan To Expand Medicaid Unilaterally

After promising to expand the state’s Medicaid program on the campaign trail, Gov. Bill Walker has announced he will sidestep the Legislature to make that happen.

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Gov. Bill Walker announces his decision to expand Medicaid unilaterally at a press conference at the Alaska Native Tribal Health Consortium on Thursday, July 16, 2015. (Alexandra Gutierrez/APRN)
Gov. Bill Walker announces his decision to expand Medicaid unilaterally at a press conference at the Alaska Native Tribal Health Consortium on Thursday, July 16, 2015. (Alexandra Gutierrez/APRN)

WALKER: Today, Alaska becomes the thirtieth state to accept the benefits of Medicaid expansion.

Medicaid expansion had been blocked by key Republican leaders. The Legislature is expected to let the decision stand — even if some don’t like it.

The Thursday announcement felt more like a victory rally than a press conference.

“I think today deserves a high-five, Governor,” said Corrections Commissioner Ron Taylor, before doing just that in front of a standing-room crowd.

At least 200 people had gathered at the Alaska Native Tribal Health Consortium office for the event, and the only place where you could find an empty chair was at a reserved table that had more seats than Anchorage has media outlets.

Standing in front of his whole Cabinet, Walker said he wasn’t going to wait any longer for the Legislature to act on Medicaid expansion. His administration had pushed hard for the policy during the regular session, and attempted to get the Legislature to take it up during their first special session — only to see them gavel out and gavel back in with the item removed.

Walker said lawmakers had their chance.

“This is the final option for me. I’ve tried everything else,” said Walker. “And one thing people have to learn about me [is] I never give up.”

Walker explained that the state would accept $150 million in federal funding so single people who are near the poverty line can enroll in the state’s Medicaid program. These are people who are too poor to be eligible for subsidies under the Affordable Care Act, but not covered in other ways.

His health commissioner, Valerie Davidson, said the decision would have a major impact on about 20,000 Alaskans.

“We have so many hard-working Alaskans who simply don’t have access to health care,” Davidson said at the press conference. “They are missing work. It is affecting businesses. They can’t take care of their children. They can’t hunt. They can’t fish. They can’t chop wood. They can’t pack water, and they can’t report to work when they’re not healthy enough to do so.”

Expanding Medicaid isn’t as simple as just telling the federal government Alaska wants the money. The governor does need to consult lawmakers, but the process is more a formality than anything else.

What happens now is that Walker asks the Legislative Budget and Audit committee to consider the appropriation request. They then have 45 days to make a non-binding recommendation on it.

“I personally support Medicaid expansion,” says Anchorage Republican Mike Hawker, who chairs that committee. “But even if I wanted to stop it in this committee, there is nothing I can do.”

In fact, Hawker says he’s even open to expediting the process, if the governor wants the funds to be accepted before September 1. But even though he supports the policy and is willing to work with the governor on it, Hawker says circumventing the Legislature will bother some.

“I’m not sure the governor’s unilateral decision to undertake expansion is, at the end of the day, the best way to go about this,” says Hawker.

North Pole Republican John Coghill is the Senate’s majority leader, and an opponent of expansion. He does not think it’s fiscally responsible to take money for the program when the federal government is running up a deficit. Coghill agrees that it will affect the governor’s relationship with the Legislature.

“It’ll put us on guard, there’s no doubt about that. But I don’t think we’ll start playing payback or anything like that,” says Coghill. “I think it’s just it gives us a little more understanding of how he’s going to make policy calls. That makes it tougher when he comes to us and has to ask for budget items.”

But even though Coghill does not like the policy, he does not expect that the Legislature will take drastic measure to block it. The only real way to stop the governor is to call a third special session. And Coghill says there isn’t enough opposition to the policy for that to happen, especially since the Republican majorities are, themselves, divided on it.

“There probably is support enough for Medicaid expansion,” says Coghill. “If you take both Houses together, you probably get a majority of people.”

For his part, Walker says while it’s the Legislature’s call, a special session to block Medicaid probably would not be productive. And based on the number of high fives and hugs the governor gave at the press conference, he’s not expecting them to try.