Alaska’s top health official said the federal health care bill scheduled for a vote on Thursday would devastate the Medicaid program in the state. The bill’s effect on Alaska has prompted U.S. Rep. Don Young to say today he won’t vote for it in its current form.
Alaska Health and Social Services Commissioner Valerie “Nurr’araaluk” Davidson said the Republican bill called the American Health Care Act would hurt Medicaid in a few different ways.
Davidson said the bill shift responsibility onto states at a time when Alaska can’t afford it. She said the state would have to cut eligibility and benefits in the program.
“I get nervous every time I hear a member of Congress talk about the great savings to the Medicaid program, because what they’re saying is, it’s a savings to the federal government,” Davidson said. “They’re not saying it’s a savings to states – they’re actually shifting that cost to states, and that’s a problem for Alaska.”
Currently, the federal government reimburses states based on their Medicaid costs. So when costs go up, so do the reimbursements.
Under the bill, the federal government pays a fixed rate per person. And health care experts don’t expect federal payment increases to match rising Medicaid costs.
Davidson also is concerned that the bill would require people on Medicaid to apply twice a year, rather than once annually. This will raise state costs to administer the program.
But more importantly, the bill would cut federal reimbursements for patients who move on and off Medicaid as their income rises and falls.
“That’s particularly a problem for a state like Alaska, where we have a significant seasonal workforce,” Davidson said.
Davidson noted that Medicaid expansion has brought $382 million in health spending to provide care for more than 30,000 Alaskans. Nearly 150,000 more Alaskans receive Medicaid, and could see reduced services.
Davidson is also skeptical of federal officials who say they want to give states more flexibility. She said it leaves states with bad choices.
“We’re the ones who get to be the bad guys, and we’re the ones who have to make the tough decisions,” Davidson said.
Alaska Congressman Don Young said he won’t vote for the bill in its current form.
Young said the federal share of Medicaid costs is one area under discussion this week, before the House vote.
“One of my frustrations in watching this bubbling cauldron of indecision is, in fact, this is part of the program that’s going to be changed,” Young said. “And there’s a lot of thoughts out there. A lot of deals. But I’m not going to put the burden back on the state.”
Young wants to repeal and replace the Affordable Care Act, but he said the bill, as drafted, isn’t fair to Alaska because it doesn’t adequately recognize the very high costs of medical care in Alaska.
“If I think we’ve come together, the delegation has, on fair, equitable treatment to Alaskans, I’ll probably vote for the bill,” Young said. “But if it’s not there, I’ll vote against the bill, because it’s really not the repeal of Obamacare as we said we were going to do.”
Davidson said she’s communicated her concerns to the state’s delegation in Congress.
APRN’s Liz Ruskin in Washington contributed to this report.
Andrew Kitchenman is the state government and politics reporter for Alaska Public Media and KTOO in Juneau. Reach him at akitchenman@alaskapublic.org.
