Alaska Editorial: Medicaid expansion makes sense

The following editorial first appeared in the Anchorage Daily News on Oct. 30:

The Alaska State Chamber of Commerce kept its feet planted firmly on Main Street in its vote to support the expansion of Medicaid in Alaska.

Along with the benefits of providing medical care for up to 40,000 Alaskans currently without insurance, the expansion looks like a sound business decision from Alaska’s point of view.

The federal government will pay for 100 percent of the expansion costs for the first three years, and then gradually decrease support to 90 percent by 2020. The state would spend about $90 million on the expansion but receive more than $1 billion in federal money. That’s a decent return, especially because Alaskans will help pay for the expansion in other states with their federal taxes. It makes sense to get something for our contribution,

Former state Health and Human Services commissioner Karen Perdue also pointed out that the Medicaid expansion would ease the millions in “cost-shifting” that hospitals and other providers do now to account for services that go unpaid by people who don’t have insurance. Those who do have insurance — and their insurers — pick up the tab. Those who have had the experience of a $50 Tylenol dose in the emergency room know how this works, and would be glad for the pain relief of less cost shifting.

Gov. Sean Parnell has opposed the expansion in Alaska, arguing that we can’t count on the feds to cover the costs as promised. And Parnell has been an outspoken, litigating opponent of Obamacare since his election in 2010.

But the governor says he is at least reconsidering. The numbers suggest he should, and the numbers have persuaded other Republican governors like Arizona’s Jan Brewer, Ohio’s Jon Kasich and Michigan’s Rick Snyder to temper their opposition to Obamacare with an embrace of Medicaid expansion.

Like the Alaska state chamber, these governors made practical decisions to benefit their residents and political decisions that appeal to the center. And they have been determined about it — Brewer refused to sign any legislation until lawmakers gave her a budget and Medicaid expansion, and Kasich has infuriated the hard right in the Ohio legislature by going around them to a state medical board for approval.

Chamber members put business sense before any ideology in their decision. They do not, by and large, endorse Obamacare — and prefer a Medicaid expansion that allows to opt out if the feds don’t cover their share. But they recognize that a piece of the Affordable Care Act provides a more rational way to help the state’s uninsured than what we have now — and a way that will bring economic benefits to the state.

Gov. Parnell should do the same.


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Some time ago, the snow was mounded everywhere, deep and wet. As I gazed from my window, contemplating shoveling, I saw a neighbor plowing out the nextdoor driveway and mailbox — and then chug over to our mailbox, and plow it out as well. Such a welcome and unrequested act of thoughtfulness, of kindness: it lifted my spirits!

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