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Advocates for Medicaid Expansion Say Governor Legally Obligated to Accept Federal Funds


February 13, 2019
Wednesday AM

(SitNews) Juneau, Alaska - According to a non-partisan memorandum from the Division of Legal and Research Services, Representatives Tiffany Zulkosky (D-Bethel), Zack Fields (D-Anchorage), and Ivy Spohnholz (D-Anchorage) say Legal Services confirms that the Governor of Alaska is legally obligated to accept federal funding to cover the Medicaid expansion population in Alaska. The memo’s author Director Megan A. Wallace notes that the governor cannot simply eliminate funding for Medicaid expansion by refusing to receive federal funds. The memo goes on to stipulate that any restriction on how Medicaid funds are to be spent must be made by statute – not the budget

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Although Governor Mike Dunleavy criticized the expansion in campaign appearances, citing concerns about the growing cost of health care and associated costs to the state to keep coverage going for a widening base of enrollees, Brett Huber, Dunleavy’s campaign manager, told Bloomberg Law in August of 2018, “We certainly aren’t running a campaign on the notion that Medicaid expansion ought to just be rolled back. We have the program in place now so we have to look at how do we go forward in the most constructive manner that’s going to use the dollars most wisely, promote the best outcomes and provide the necessary access to medical care that people need.”

“Expanding Medicaid access to Alaskans just barely above the poverty line was the right and moral thing to do, and it is the right thing for Governor Dunleavy to continue. Eligibility, cost, and access should not be barriers to advanced medical care that protects the life and limb of our friends and neighbors,” said Rep. Zulkosky. “The federal funding that Medicaid expansion brings to our state provides essential resources that help thousands of Alaskans remain in the workforce or to get back into it. Those dollars enable hospitals across the state to continue offering local, accessible, and compressive care. Hopefully, Governor Dunleavy will follow the advice of the legal and healthcare experts by keeping Medicaid expansion in place in Alaska. “

“Medicaid expansion is essential for our state’s efforts to control health care costs and fight crime by expanding addiction treatment. Medicaid expansion has reduced the cost of uncompensated care at hospitals, which saves money for Alaskans who are covered by private health insurance. Alaska’s leading business organizations advocated for Medicaid expansion based on a need to reduce uncompensated care and bring new investment to the state,” said Rep. Fields. 

“The evidence is clear that Medicaid expansion is good for Alaska, good for our economy, and Alaskans support it. If Governor Dunleavy wants to end Medicaid expansion, he needs to file a bill and convince lawmakers it’s the right thing to do. Medicaid expansion has insured 37,000 working Alaskans and has been a lifeline for our economy through the recession. A recent analysis found that eliminating Medicaid Expansion in Alaska would cost Alaska’s economy nearly 3,700 jobs, $267 million in annual labor income, and $556 million in annual total economic output under State Fiscal Year (SFY) 2018 conditions. That’s not a cost Alaskans should be willing to accept,” said Rep. Spohnholz.

Medicaid expansion in Alaska started in 2015 and has brought nearly $1 billion in federal investment to the state while ensuring 37,000 Alaskans have health insurance. Since expansion was implemented, health care is the only industry sector in Alaska that has consistently added jobs, moderating the impact of the ongoing recession brought on by low oil prices. 

The Alaska State Hospital and Nursing Home Association (ASHNHA) also commented on the new report. They assert repealing Medicaid Expansion would prolong the state’s recession, and cost thousands of jobs. 

The report, commissioned by ASHNHA and compiled by economist Jonathan King, estimates the effect of removing $420.1 million from the Alaska economy, the amount spent on Medicaid Expansion in State Fiscal Year 2018. 

In addition, the new report concludes that eliminating Medicaid Expansion would cost the Alaska economy more jobs than it is expected to grow in 2019 the  Alaska State Hospital and Nursing Home Association stated in a news release.

The federal government’s matching funds are responsible for much of the economic impact. For calendar year 2019, the federal match is 93 percent, which means that for every dollar spent on enrollee benefits, the State of Alaska pays seven cents. “This is powerful leverage of state monies”, said report analyst and author Jonathan King.

King said the data also paints a stark picture of how Alaska would be impacted by the loss of Medicaid Expansion. “Elected officials can debate the politics of this issue, but not the numbers; economic analysis shows how rejecting these federal dollars would hurt Alaska’s economy. Our economy is too fragile absorb this size hit without extending the recession,” said King. 

“The case is clear for maintaining Medicaid Expansion,” said Becky Hultberg, ASHNHA president and CEO. “Not only does it preserve health care for 50,000 Alaskans, but it also makes economic sense. Any decisions made on this issue must be grounded in facts, not rhetoric. We believe this report provides compelling evidence that Medicaid Expansion improved our economy and should remain in place.” 


On the Web:

The Economic Effects of Repealing Medicaid Expansion in Alaska (pdf)

MEMORANDUM: Medicaid Expansion: Division of Legal & Research Services Legislative Affairs Agency State of Alaska (PDF)



Reporting and Editing by Mary Kauffman, SitNews



Source of News:

 Office of Rep.Tiffany Zulkosky (D-Bethel)

Office of Rep. Zack Fields (D-Anchorage)

Office of Rep. Ivy Spohnholz (D-Anchorage)

Alaska State Hospital and Nursing Home Association

The Alaska State Hospital and Nursing Home Association represents more than 65 hospitals, nursing homes, and other healthcare organizations that employ more than 10,000 Alaskans. Its membership spans geographically from Ketchikan to Utqiagvik.


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