Sitka urges Governor to accept Obama’s Medicaid plan

President Barack Obama signed the Patient Protection and Affordable Care Act into law at the White House on March 23, 2010.

President Barack Obama signed the Patient Protection and Affordable Care Act into law at the White House on March 23, 2010. (Photo by Pete Souza)

Several organizations around the state have recently asked Governor Parnell to expand Medicaid under the Affordable Care Act, including the Anchorage NAACP, the Anchorage Chamber of Commerce and the Alaska Chamber.

The Sitka assembly didn’t go so far as endorsing Medicaid expansion. But at its meeting this week, the assembly passed a resolution asking Parnell and the state legislature to “fully consider” the benefits to Alaskan communities of expanding Medicaid to cover a larger share of the state’s poorest residents.

The US Supreme Court’s ruling on the Patient Protection and Affordable Care Act — also known as Obamacare — in the summer of 2012 left open the possibility for states to opt out of the law’s Medicaid provision.

Alaska was one of the states to bring that lawsuit, and Gov. Parnell remains vocal in his opposition to the law, but he hasn’t officially said “no” to the Medicaid option — not yet. He’s mostly worried about having to pick up the bill.

Here’s what he told me when he visited Sitka back in October.

“I can’t trust the federal government to keep its word. I think I can trust the Obama administration that they’re going to fund the next two or three years. I don’t have a problem with that. It’s what happens after that.”

Parnell’s got until December 15 to decide whether to accept the federal government’s offer to increase the number of residents eligible for Medicaid. That’s when he submits his budget to the legislature.

The Sitka assembly did not share the governor’s concern. They mainly wanted to send a message that the bottom line was about getting health coverage for Alaskans too poor to buy it on their own. That — and the actual bottom line.

This is deputy mayor Matt Hunter:

“A lot of the people who would benefit by this would still seek care in Sitka, and receive care in Sitka — for free, because no one pays their bills. Except the rest of us who pay our bills, which are marked up to cover their bills. So, we’re all paying for it, and this would be a huge economic boost. We look at $1-million a year in charity care at Sitka Community Hospital alone — just one of our two hospitals. That’s a lot of money that would be coming into town that isn’t otherwise.”

But the assembly also recognized that the Affordable Care Act was at the heart of an ongoing partisan struggle in Washington DC — a struggle where few have been willing to give up ground, even if it directly benefits low-income citizens or the disabled. According to former Commissioner of Health and Human Services Myra Munson, 41,500 Alaskans will be covered if the state participates in the Medicaid expansion.

Assembly member Pete Esquiro asked city administrator Mark Gorman for his opinion on the issue. Gorman, who’s had a 30-year career in Public Health, said there was no doubt that the expansion would benefit Sitkans and local hospitals, but…

“Where there is reluctance to go in this direction, state houses are run by Republican governors. I think it goes back to the issue that it’s largely a partisan debate.”

United States map indicating which states are expanding Medicaid coverage in 2014. Blue indicates states which are expanding Medicaid, red indicates states which are not, and gray indicates states that are still debating expansion as of July 2013. (Wikipedia Commons)

United States map indicating which states are expanding Medicaid coverage in 2014. Blue indicates states which are expanding Medicaid, red indicates states which are not, and gray indicates states that are still debating expansion as of July 2013. (Wikipedia Commons)

Assembly member Ben Miyasato said that there has been no time in the last 40 years that health care has not been a partisan debate. He supported the grassroots nature of the resolution.

“What it will do, if enough communities pass this and get it out there, I think this is more ammunition for the governor to rethink his decision.”
Mike Reif was more trusting than the governor of the Obama administration’s funding plan. He called it “a pretty good deal for states.”

Pete Esquiro hesitated, but eventually cast a “yes” vote. The resolution passed 6-0. Mayor Mim McConnell, who sponsored the resolution with Phyllis Hackett, was out on a family emergency.

According to data supplied in the assembly packet, 18 states have adopted the Medicaid expansion, five are leaning “yes,” five are leaning “no,” 10 are firm “no’s,” and 12 — including Alaska — are undecided.

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