Anchorage Daily News - Parnell Opposed to Medicaid Expansion Now

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By BECKY BOHRER

Alaska Gov. Sean Parnell said Thursday he is opposed to expanding Medicaid in the state, given what he knows about the federal budget.

Parnell told reporters he will not ask the Legislature this session for funding or authorization to expand the program. He said he will continue to study the issue, with his next decision point coming when he submits his next budget in December.

At this point, "both the Legislature and I and the Alaska people need to see that it's in our interest as a state before we go down that road, and right now, I don't see that's the case," he said. "But I'm open to being proven differently."

The choice of whether to expand Medicaid arose from last year's U.S. Supreme Court decision upholding most of the federal health care overhaul. The court held that states can't lose existing Medicaid funding if they don't expand their Medicaid coverage levels. Starting Jan. 1, the health care law expands Medicaid eligibility to people making up to 138 percent of the federal poverty line, or about $15,400 for an individual.

Expansion in Alaska would cover an additional 32,000 people at a cost of nearly $220 million, starting in 2014, according to a 2011 state report. The federal government is expected to cover the cost of the expansion for the first three years, through 2016, and cover the bulk of the cost indefinitely, with states contributing.

"As I have said, I do not think politics should get in the way of protecting tens of thousands of Alaskans and reducing coverage costs for everyone - additional Medicaid coverage is good for small businesses, it is good for families, and it is good for our long-term economic security," said U.S. Sen. Mark Begich, D-Alaska, who supports expansion.

Parnell recently returned from a meeting of the National Governors Association in Washington, D.C., and said Washington is broken and broke - and going from crisis to crisis and with the president and Congress blaming each other.

"At this point, the federal government cannot even say with certainty that it can meet its obligations to cut welfare checks on April 1, let alone finance Medicaid expansion," he said.

The Republican governor said he met with U.S. Health and Human Services Secretary Kathleen Sebelius and told her he was concerned the federal government could renege on its promise for funding much of any Medicaid expansion. He said the state will approach decisions on expansion in a financially responsible way, making sure current beneficiaries are protected and that any expansion is financially sustainable by the state if the federal government cuts its commitment.

He said he asked if the state could have flexibility in implementing an expansion, that is, to implement a more limited expansion and have more people use the new health care exchanges that also are to be set up under the law. Sebelius said she didn't think she had that kind of flexibility, to allow for partial expansion, he said.

An exchange is a marketplace for coverage options. Parnell had earlier decided to let the feds set up the exchange for Alaska, saying "federally mandated programs should be paid for by federal dollars."

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