The first day of Medicaid expansion wasn’t Black Friday. For Alaska’s Public Assistance Offices, it was just a slightly busier Tuesday in the office.
“We did see an increase in work, but it wasn’t to the degree that it was unmanageable,” said Sean O’Brien, the head of the Division of Public Assistance.
According to figures supplied Wednesday by the Alaska Department of Health and Social Services, 252 Alaskans dropped off completed application forms directly at offices on Sept. 1. Another 104 applications were submitted online, and Southeast Alaska Regional Health Corporation dropped off 46 applications in Sitka.
Twenty-seven applications were turned around by office staff in the first day, and those applicants now have health insurance.
Another 527 Alaskans received insurance through emergency care programs in separate processes also affected by Medicaid expansion.
“It was a very good day with a lot of hard work by many folks in the field,” O’Brien said.
Under orders from Gov. Bill Walker and with funding from the Alaska Mental Health Trust, the state began offering expanded Medicaid coverage on Tuesday.
The expansion allows Alaskans who earn up to 138 percent of the federal poverty line ($20,328 per year for single adults or $27,492 per year for married couples) to apply for federally subsidized health insurance.
Expansion has been a hotly contested issue, and in late August the Legislative Council — a joint body of the Alaska Legislature — launched a lawsuit to stop the state from beginning expanded coverage.
An Alaska Superior Court judge declined the council’s request for an injunction, as did the Alaska Supreme Court, allowing the state to begin expanded coverage as scheduled.
O’Brien said his office had been preparing for expansion even as the lawsuit was debated in an Anchorage courtroom.
“We knew in order to launch Sept. 1, we had to plan on moving forward,” he said. “We had to continue to do everything we needed to do to be ready … otherwise, we wouldn’t have been able to launch.”
The state expects about 20,000 more Alaskans to apply for insurance coverage. Other estimates range as high as 41,000.
“The 20,000 sounds like a big number … but it really is modest when you start talking about the overall volume of work we have to manage through our public assistance offices,” O’Brien said.
Last year, the state processed almost 110,000 claims of all kinds through its public assistance offices.
Not all of those applications were finished quickly, leading to a backlog. In April, the state reported that 9,175 applications had been waiting to be processed for more than 30 days.
By Wednesday, that backlog had dropped to 7,878 cases thanks to a drop of almost 550 in the past two weeks.
“We still have quite a few to go, but statistically, that’s a very significant drop,” O’Brien said. “We’re continuing to work on it.”
To deal with the backlog and the surge in applicants expected under expansion, the Division of Public Assistance is bucking the state’s trend toward cutbacks by hiring new staff, 21 all told.
The Alaska Mental Health Trust is supplying $1.5 million to pay the administrative costs of the first year of expansion, and the federal government is paying the full cost of insurance coverage once applicants are processed.
Beyond the state offices, others are working hard in the first days of expansion. Andrea Thomas, an outreach and enrollment manager for SEARHC, was spending Wednesday in Kake helping people through the application process. She’s already been to Haines and Angoon.
“Once we found out that Medicaid was going to expand, we have been reaching out to uninsured people in our region,” she said. “We’ve now submitted over 50 in just these first few days and I have a stack to submit when I get back to Sitka.”
In rural Southeast, there are plenty of people who are now eligible for Medicaid who weren’t before, she said.
“I’ve helped students that are on their own … I’ve helped quite a few people that are self-employed, people that fish and have gotten an injury or it’s been a poor fishing year and they aren’t making much money,” she said.
Both the state and Thomas stressed that online applications, whether through healthcare.gov or my.alaska.gov (the same place Alaskans apply for the PFD) are much faster in terms of turnaround.
“That’s the quickest, best way to apply for Medicaid, and then they can track it themselves,” Thomas said.
Paper applications make up much of the backlog, as any errors send the application back to the applicant, slowing the process.
O’Brien added that anyone considering applying for Medicaid coverage under the expanded guidelines may be better off waiting until Nov. 1. Expanded federal subsidies will be available through healthcare.gov, and the state is planning software upgrades that may make processing faster.
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