Potential initiatives would enshrine Medicaid expansion, ACA provisions in state law

Supporters of Medicaid expansion express their views at the state Capitol in April 2015. Doctors are sponsoring two initiatives that may appear on the 2018 ballot, one of which would enshrine the expansion in state law. (Photo by Skip Gray/360 North)

While Congress has debated repealing the Affordable Care Act, some doctors want to make sure that at least parts of the law remain in place in Alaska. They’re sponsoring two initiatives that could be on the ballot next year.  

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One initiative would enshrine in state law the Medicaid expansion that Gov. Bill Walker executed. The other initiative would include several other provisions of the Affordable Care Act in state law. 

Anchorage Dr. Graham Glass is one of the sponsors of the Medicaid expansion initiative. His neurology and sleep medicine practice has seen a difference from the expansion. 

“We see patients that otherwise we probably would have never seen,” Glass said. “We’re able to do things such as treat their sleep apnea earlier on, before they have heart attacks and strokes and then end up being seen in the hospital as uninsured patients.” 

Glass noted that if Medicaid didn’t cover those patients, the cost to provide emergency care to them would be shifted to patients with insurance. 

The Medicaid expansion has covered 35,390 more Alaskans. Another 31,096 signed up for Medicaid or Denali KidCare since the ACA went into effect.  

Glass said the political support for federal funding for the expansion means the state should be able to afford it. 

“The fact that we have a Republican president and a Republican Congress, and they were still unable to pass that repeal in any way, shape or form, makes me fairly comfortable that moving forward in the next administrations for years in the future, it’s very unlikely that that federal money will go away,” Glass said.

The other initiative would require insurers to cover people with pre-existing conditions. It also would allow parents to cover their children until they turn 26. And it would require health plans to have 10 essential benefits, including mental health care and prescriptions. 

Both initiatives are being reviewed by Lt. Gov. Byron Mallott’s office to ensure they’re eligible to be placed on the ballot. For instance, they can’t require the state to appropriate money.  

Andrea Nutty with the Alaska Nurses Association said the union’s members will support gathering signatures for the petitions. She said it’s important that the ACA protections remain in place.  

“With the current instability in Washington, D.C., it’s vitally important to establish patient protections on a state level,” Nutty said.

Some Alaskans, including U.S. Sen. Dan Sullivan, have called for ACA mandates to be scaled back in order to make insurance more affordable. 2,200 Alaskans buy individual insurance or family insurance costing roughly $1,000 a month, because they don’t receive subsidies based on income. But another 14,000 Alaskans who are subsidized pay an average of $93 a month. 

Nutty said there are other ways to reduce the cost of health care, beginning with making prices more transparent to the public. 

“It’s still vitally important that all of those essential health benefits are included in all insurance plans, because you can’t predict when life is going to throw you a curve ball,” Nutty said. 

Mallott has until early October to review the initiatives. If he approves them, the sponsors must gather 32,127 signatures to petition to place each initiative on the ballot.  

Andrew Kitchenman is the state government and politics reporter for Alaska Public Media and KTOO in Juneau. Reach him at akitchenman@alaskapublic.org.

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