Alaskans among those having least health-care coverage

22 percent of state's adults 21 to 65 have no health insurance

Posted: Monday, November 29, 2004

KENAI - The percentage of Alaska adults without health insurance ranks among the highest in the nation, according to a report.

Alaska, like the rest of the country, also faces rising costs for long-term care, child care, Medicaid and prescription drugs, according to the study funded by the Pew Charitable trust.

The study was conducted by Governing Magazine and the University of Richmond. It found 22 percent of adults between 21 and 65 had no health insurance. Only eight states had higher rates.

Alaska did somewhat better when it came to covering children under 18. Between 10 and 15 percent were uninsured, which put the state 35th among states.

The study found that state-run health care systems were unable to deliver improvements in medicine fairly and consistently to many of their citizens, in part because rising costs were overwhelming state budgets.

Alaska is unique in that its annual budgets are tied directly to the production and price of oil. If prices remain at their current levels, at least $400 million to $450 million of additional revenue could allow state lawmakers to reverse at least some of the budget-cutting trends of the past several years, including within the budget of the Department of Health and Social Services.

The department's budget has risen even as the department has meshed some programs, zeroed funding to others, eliminated positions, consolidated grants and contract functions and made other changes.

Earlier this year, a retiring Homer public health nurse with 25 years of experience said reduced travel budgets had affected local health services.

Among other things, nurse Donna Fenske said there was a need for maternal and child-care education outreach programs. Fenske said she has seen programs come and go as they were impacted by political choice or lack of funds.

Health and Social Services Commissioner Joel Gilbertson said the department is considering budget requests that would take into account the unexpected oil revenues. But he said he wouldn't couch any increases in terms of reversing trends.

Past changes to department programs, he said, were the result of analyzing their effectiveness and taking appropriate steps that while made with the budget in mind, were not driven entirely by the bottom line.

"If programs were not working, we stopped funding them and directed the money to those that were," he said.

At $1.7 billion in fiscal year 2005, Health and Social Services represents the largest segment of the state's operating budget. Nearly $1 billion of that is associated with Medicaid. The increasing cost of long-term care, home health programs, prescription drugs and the like are straining available state and federal dollars.

Today, some 145,000 Alaskans hold a Medicaid card. More than 120,000 of them used it in the past year. That number will grow as the population ages, Gilbertson said.

"We are getting close to a quarter of the population using the system," he said. "That's a tremendous financial burden."

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