The Legislative Council is moving forward with their lawsuit to stop Medicaid expansion. In the meantime, both the legislature and the Walker administration are working with consultants to find ways to reduce the cost of the Medicaid program.
Lawyers for the Legislative Council are considering filing a motion in Superior Court in the next few weeks that would kick off the next phase of the case.
In late August, Superior Court Judge Frank Pfiffner ruled against a preliminary injunction that would have blocked Medicaid expansion from starting on September 1st. In that decision, he said the Legislative Council failed to prove it was likely to win on the merits if the case moved forward.
But Senate Majority leader John Coghill still thinks the legislature has a strong case against the governor:
“Does the governor have the authority to get the state entangled in things that the legislature by law is supposed to appropriate for? I think we have to get the answer to it. This just brings the answer up very clearly in my mind.”
The case hinges on whether the Medicaid expansion population is an optional or required group under federal law. The Governor needs legislative approval to add an optional group to the program.
Coghill knows a final decision in court won’t come quickly- possibly not until after next year’s legislative session. He thinks there’s support for continuing Medicaid expansion in the legislature. But he says that support hinges on another issue that will be front and center during the legislative session- Medicaid reform:
“My expectation is the reforms are very important because our regular Medicaid population payment system now is just not sustainable to our budget, and it’s not sustainable in our growth pattern.”
This month, the Legislative Budget and Audit Committee approved hiring a consulting firm to study Medicaid expansion and reform. And Coghill says he sees the lawsuit as a way to put pressure on the governor to work with the legislature, to bring down the cost of the state’s Medicaid program.
Governor Walker included several cost cutting reforms in the Medicaid expansion bill he introduced last session. And the state’s health department is working with a consultant to look for other ways to reduce Medicaid costs and streamline services.
Representative Les Gara, an Anchorage Democrat, says there is broad support for Medicaid reform:
“There’s no need to keep the pressure up. The Governor understands, Democrats understand, Republicans understand, we need to find ways to save money.”
Nearly 1000 Alaskans have enrolled in Medicaid expansion since the state began accepting applications at the beginning of the month. But about half of those enrollees transferred to Medicaid from a state program that paid for healthcare for very low income residents with chronic or terminal medical conditions.