Bartlett, SEARHC optimistic about Medicaid expansion's effects

Alaska Dept. of Health and Human Services Commissioner Valerie Davidson, left, speaks at a news conference in Anchorage, Alaska, Thursday, July 16, 2015. During the news conference, Gov. Bill Walker, front right, announced he intended to accept federal money to expand Medicaid coverage in the state. (AP Photo/Mark Thiessen)

Juneau’s city-owned hospital expects 2,400 additional locals will be eligible for Medicaid now that Gov. Bill Walker has accepted close to $150 million in federal dollars to expand the health care program, a spokesman for Bartlett Regional Hospital said.

 

Bartlett hopes about half of those people sign up for insurance through the program, Jim Strader said.

In fiscal year 2015, the hospital saw 1,500 patients who were covered by Medicaid. If the program grows in the state, single adults earning up to $20,314 per year and married couples earning up to a combined $27,490 per year will be eligible for coverage.

More covered people means less pressure on the hospital’s bottom line. When people without insurance have a medical problem, they often turn to the emergency room for care, causing the hospital to provide medical attention that goes unpaid for, he said. The hospital is on the hook for $10 million to $13 million per year in uncompensated care, according to a Bartlett Board of Directors document.

Bartlett estimates that expanded Medicaid, for which the state estmates about 40,000 additional Alaskans will be eligible, will make up for $1 million in uncompensated emergency room care at the hospital, Strader said.

Bartlett’s not alone in this thinking, he said.

“The general feeling in the medical community is that expanding Medicaid to people who are uninsured will increase primary care and will reduce impact on hospital emergency rooms,” Strader said.

Though the governor’s Medicaid expansion bill was blocked in the Legislature this year, Bartlett management was expecting expansion, Strader said.

“The anticipation was that it was coming; the hope was that it was coming,” he said.

If the Walker administration sticks to the timeline it’s proposed and Medicaid is expanded in Alaska starting Sept. 1, more adults between the ages of 19 and 64 would be eligible for coverage.

George Brown, a recently retired Juneau physician who has practiced medicine in Alaska since 1965, said this might address a growing problem in the health care industry — young adults skipping out on health insurance.

“Medicaid expansion is going to cover a whole lot of young adults who don’t have any insurance,” he said. “They don’t think they need it and (they want to) spend money on other things.”

And maybe they don’t — until something bad happens, Brown said. Then they end up going to the emergency room for care.

“That’s part of why our health care is so expensive this country,” he said.

Medicaid expansion could help fix “a problem that’s not going to go away” any time soon, Brown said.

“This is going to take time and it’s gradually happening — (giving people) a medical home, a place they know they can go when they’re sick, so they don’t go to the emergency room so much,” he said. “A huge amount of money is wasted by people going to the emergency room when they dont need to.”

Brown said about 10 percent of the patients he saw as a pediatrician in Juneau were uninsured.

The Southeast Alaska Regional Health Consortium hopes expansion will patch a similar hole for the Native health care organization.

SEARHC provides prepaid care for Alaska Native and American Indians. The federal Indian Health Service pays for about 50 percent of that every year, CEO Charles Clement said. The rest of SEARHC’s health care services are paid by insurance and grants.

The more people who have Medicaid coverage, the more often SEARHC can send Medicaid a bill for the services it provides, Clement said.

“We use those proceeds to cover the gap” between IHS and grant funding, he said.

SEARHC has provided health care for about 28,000 people over the past three years. Clement said he doesn’t have an estimate for how many more SEARHC patients will be covered by Medicaid if it is expanded.

He said the health care industry is generally excited to “reach a little further than we may have been able to do” through expanded Medicaid.

“Most of us are in this to help as many people as we possibly can,” Clement said.

An Alaska Native Tribal Health Consortium-funded study on Medicaid expansion estimated 4,000 new jobs would be created in Alaska because of the federal dollars infused into the economy. A Bartlett spokeswoman said the hospital does not intend to hire more medical professionals because of expansion.

Clement said SEARHC will be hiring more medical staff this year. Though that’s not related to Medicaid expansion, expansion “should help us ensure that it will be financially viable” to hire more people.

According to the same study, about 66 percent of the added economic activity associated with Medicaid expansion is expected to occur in Southcentral Alaska.

Walker’s decision to accept federal money to expand Medicaid this year will be taken up by the Legislative Budget and Audit Committee. But regardless of what the committee recommends, the governor has the authority to go forward with expansion Sept. 1.

Both the Legislature and the Walker administration are hiring consultants to help reform and repair broken pieces of the state’s current Medicaid system. The Republican-led Legislature was unwilling to expand Medicaid itself without reforms already in place.

The federal government will pay for the broadened Medicaid program in full this calendar year, but will ramp down funding incrementally to 90 percent by 2020.

• Contact reporter Katie Moritz at 523-2294 or at katherine.moritz@juneauempire.com. Follow her on Twitter @katecmoritz.

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