Health Care Providers Push Governor Parnell to Expand Medicaid

The Supreme Court largely left the Affordable Care Act intact over the summer, though it struck down the key provision forcing states to swell the ranks of Medicaid recipients.

Governor Parnell is withholding his decision on whether to expand Medicaid until he gets results from a cost analysis.

A few months ago, he indicated to APRN he’s erring towards no.

“If I had to make the decision today, I would not expand Medicaid over concerns of costs and the uncertain future of Medicaid on the federal side,” he said in a phone interview last summer.

The federal government pays about half the state’s 1.2 billion dollar Medicaid tab. Alaska pays the rest.  But the Obama administration is offering a much better deal for the Medicaid expansion: The federal government will pay 100% of the expansion in years 2014, 2015, and 2016.

Karen Perdue, president and CEO of the Alaska State Hospital and Nursing Home Association, a group that wants Governor Parnell to expand the Medicaid rolls, said medical providers in Alaska could stand to make hundreds of millions of dollars more over the next decade.

“The hospitals would receive about $561 million over several years in revenue that probably would not come in the door,” she said.

Revenue that would not come in the door if the governor opts to not expand the Medicaid ranks. The number Perdue cites comes from a new Kaiser Family Foundation study released this week.

Perdue said hospitals need the expansion and extra revenue because under the Affordable Care Act, providers in Alaska could lose up to $25 million dollars per year in Medicare reimbursements.

“Alaska hospitals, most of which are small, community hospitals, municipal hospitals, nonprofit hospitals, would really be impacted by the Medicare reductions,” she said.

Ann Secrest is with AARP Alaska. She said expanding the rolls makes sense.

AARP tends to pick its fights over Social Security and Medicare. But Secrest said AARP members are not uniform, and an expansion to Medicaid could directly affect them.

“Many of our members are still working,” she said. Many of them are under 65. Many of our members are what we call dual eligible.”

Dual eligible – meaning able to qualify for both Medicare and Medicaid. The group AK Health Reform estimates that more than 32,000 new people – mostly childless adults – could become eligible for Medicaid under the expansion.

Delisa Culpepper is the chief operating officer at the Alaska Mental Health Trust Authority. Her group funds mental health providers in the state.

And though the Authority has not taken an official position on the expansion, she said she’s excited about Medicaid potentially insuring people who haven’t qualified before.

“Medicaid is a medical model. It makes people meet a certain threshold of mental illness to get any services – as well as income,” she said.  “And because of that there are a lot of people that don’t fit in and aren’t eligible for Medicaid because only certain populations are.”

Under the expansion, the rolls would be open to people making less-than $18,500 per year. And, Culpepper said, right now the state largely restricts eligibility to the elderly, mothers and pregnant women.

Because of that, she said, people are being left out who need vital services.

“Medicaid doesn’t always fund, especially for the adult population, treatment for substance abuse and alcohol.”

There is no deadline for the governor to decide whether to expand the Medicaid rolls. But the 100% federal contribution only applies to the first three years of the program.