Lawmakers discuss Medicaid expansion

File – Alaska Gov. Bill Walker, right, gives first lady Donna Walker a hug following a news conference in Anchorage, Alaska, Thursday, July 16, 2015. During the news conference, Walker announced he intended to accept federal money to expand Medicaid coverage in the state.

JUNEAU — The chairman of the Legislative Budget and Audit Committee said Wednesday that he will take under advisement requests to hold a hearing on Gov. Bill Walker’s proposal to accept federal funds for Medicaid expansion.


But Rep. Mike Hawker, R-Anchorage, said Walker has the ability to pursue his plans regardless of what the committee says.

Near the end of a committee meeting in Anchorage Wednesday that was focused largely on a presentation of a school funding study, Sen. Anna MacKinnon, R-Eagle River, asked that a meeting be held soon so committee members could hear and vote on Walker’s plan.

State law lays out a process by which a governor is to submit to the committee for review plans to accept and spend additional federal or other program funds. Even if the committee disagrees with the plan, the governor can proceed.

Hawker said Walker has indicated his decision is final. Hawker said there was nothing of substance for the committee to accomplish on this.

The House and Senate Finance committees have Medicaid bills before them, and Hawker suggested those may be more appropriate places for policy discussions where there can be a “substantive outcome.”

Walker last week announced his plans to move forward with expanded Medicaid coverage, an issue tabled for further review by legislative leaders earlier this year. The Legislature’s top attorney and state attorney general have said that language added to the state budget by lawmakers seeking to restrict spending for expansion could be unconstitutional.

In a statement following Walker’s announcement last week, Hawker indicated he had not decided what action, if any, the committee might take. He said that while he personally supports expansion, he would have “preferred a process that would have ensured expansion is sustainable, particularly in these challenging financial times.”

Under the law, once the plans are submitted to the committee, 45 days must pass before the governor can move ahead, unless the committee earlier recommends the state move ahead. The administration submitted Walker’s plans last Thursday.

If the committee holds a hearing and there’s a vote by members, that would immediately trigger Walker’s ability to pursue his plans, Hawker said.

Sen. Cathy Giessel, R-Anchorage, said she understands what the law says, but said the opportunity to publicly review the documents submitted by Walker’s administration is part of members’ responsibility and authority. The legislative and executive are separate but equal branches of government, she said Wednesday in supporting MacKinnon’s request for a hearing.

MacKinnon said it is the panel’s job to approve or at least comment on a spending issue, certainly of the magnitude at issue with expansion. MacKinnon also is a co-chair of Senate Finance.

Legislative attorney Megan Wallace, in a memo requested by Hawker’s office, said that since the express language of the federal health care law makes coverage of newly eligible individuals for Medicaid mandatory, she believed a court would likely find coverage of those newly eligible individuals as mandatory, not optional, and that Walker would likely be within his legal authority to move ahead.

But the question has not been answered by a court, she said.

In 2012, the U.S. Supreme Court, in upholding most of the federal health care overhaul, gave states the option of expanding Medicaid, finding that states can’t lose existing Medicaid funding if they don’t.

A change in state law would be needed to expand Medicaid if the newly eligible individuals were considered an optional group, Wallace wrote.


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