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November 17, 2014 12:00 AM

Alaska's Medicaid future uncertain despite pro-expansion governor

Virgil Dickson
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    Alaska Gov.-elect Bill Walker's finally determined victory Saturday over incumbent Republican Sean Parnell could mean Alaska will be one of the next states to expand Medicaid. But whether the GOP-controlled Legislature will attempt to block such a move is open to debate.

    “I would hope the Legislature would try not to block him on his first major policy move,” said Les Gara, a Democratic member of the Alaska House of Representatives.

    Walker ran a campaign that included criticizing the Legislature, a tactic that could come back to haunt him in a Medicaid expansion fight, said Tom Anderson, a political consultant and former Republican state legislator who is now a partner at Optima Public Relations.

    “As candidate Walker, he spent the past six months telling Alaskans that the Legislature is wrong,” Anderson said, noting Walker's criticism of how the lawmaking body has put together its budget. “I'm unsure how that antagonistic approach will resonate with policymakers once he's positioned as governor and trying to cooperate with them.”

    Walker, a former Republican who ran as an independent with a Democratic running mate, is on record as saying he would immediately begin efforts to expand Medicaid once he assumes office in January. If he succeeds, as many as 41,000 people could benefit.

    Alaska is the only state where the Nov. 4 election resulted in an anti-expansion Republican incumbent governor being replaced by a pro-expansion governor. Democratic Tom Wolf did take the governor's seat in Pennsylvania from Republican Tom Corbett, but that state already had moved ahead with its own version of expansion.

    The Alaska state Legislature doesn't need to vote to expand Medicaid but it does need to agree to accept the federal funding to do so, according to Jim Lottsfeldt, a principal at Lottsfeldt & Associates, a nonpartisan government relations firm based in Alaska.

    The chances that the GOP-controlled House and Senate will agree to expand are unclear. “The Legislature has been silent on this issue because Gov. Parnell was so quick to say he wasn't going to do it,” Lottsfeldt said.

    One hurdle Walker will face is the $5 million initial price tag of expansion. The money is needed to adapt state infrastructure, including making software changes, and to add enrollment and processing personnel for Medicaid applications, according to the state's health department.

    “Walker has not yet identified where he's going to get these funds,” Anderson said.

    Expansion would mean additional federal Medicaid funding of from $2.1 billion to $3.7 billion by 2020, according to UnitedHealth Group subsidiary Lewin Group, a healthcare consulting firm, so that may make the initial investment battle easier to sell.

    But given the uncertainty, state residents should brace themselves for a potentially long wait before expansion becomes reality there, said David Shurtleff, a former political correspondent for public radio and vice president in the Alaska offices of Strategies 360, a lobbying firm.

    “This will take some time to get done. [Walker] is a measured, judicious step taker and would rather get it done right than get it done fast,” Shurtleff said. Walker will likely have the support of the state's Chamber of Commerce and countless other organizations that support expansion, he said.

    Spokespeople for both state Sen. Charlie Huggins, president of the Senate, and Mike Chenault, speaker of the House, declined to comment.

    A request for comment from Walker was not returned.

    Follow Virgil Dickson on Twitter: @MHvdickson

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