Four Alaskan Senators Point Out "Alaskans are among the least insured in the nation with 20.6 percent of our state living without health insurance" And Ask Governor What He Plans To Do About It

I reported recently that Alaska Senator Bill Wielechowski had sent a public records request to the Parnell administration requesting that the Lewin Group study of the impact of expanding Medicaid in Alaska under the Affordable Care Act be made public.  (It was completed in April.)

Today the Senator was joined by Senators Berta Gardner, Johnny Ellis, and Hollis French in a letter to the Governor asking him not only to release the report, but to get moving since the time for signing up for insurance has already begun.  Particularly, they note that Parnell's administration has abdicated any participation in the insurance exchange for Alaska, thus leaving it totally to the federal government with no Alaskan input. 

They also note Alaska's low level of health insurance coverage and a study by the Alaskan Native Tribal Health Consortium (ANTHC) that finds many benefits for Alaskans in expanding Medicaid. 


Here's the beginning of the Senators' letter:

Governor Sean Parnell
550 W. 7th
Avenue, Suite 1700
Anchorage, AK 99501
4 October 2013

Dear Governor Parnell,

Fall is upon us, and with it, the implementation of the Affordable Care Act. While many provisions of the Act have yet to take effect, one of the more important changes, the health insurance marketplace, has just come online October 1st of this year. With this deadline only recently passed, we believe now is the appropriate time for your administration to address a variety of questions Alaskans have regarding the state’s role in ensuring a smooth transition into a more affordable, efficient health care system. 

We’ve heard, mostly from media sources, that the exchanges have yet to be set up and that your administration decided not to participate in any decision-making processes that would have allowed for an Alaska-specific exchange. While we question the wisdom of giving up Alaska’s ability to have an exchange specifically designed for and adaptable to Alaska’s unique needs, that decision is past, and we hope to have a more public and open discussion about expanding Medicaid in Alaska.

According to a study by The Society of Actuaries, Alaskans are among the least insured in the nation with 20.6 percent of our state living without health insurance. The study found that, should you decide to accept the Medicaid expansion, the percentage of uncovered Alaskans would drop to just over 8 percent.

It is critically important for legislators, as well as the public, to have access to the information the administration is using to make its decision with regards to the Medicaid expansion. We ask that your administration finalize the Alaska DHSS sponsored Lewin Medicaid Expansion Recommendation Report so that Alaskans can more fully understand the issues and benefits. .  . 

The whole letter is here.

I would also recommend that the Senators, if they haven't already, look at 

the study the Lewin Group did for the State of New Hampshire.  (Phase I)

It shows huge advantages for the state in expanding Medicaid, far more than the costs.  I'm not sure what New Hampshire contracted Lewin to study, but my look at the Alaska contract with Lewin caused me to believe that they were basically asked to look at what it would cost and not how the state might benefit. 

Here's the Table of Contents for Phase II (January 2013) of the study: (Note, this is Phase II)

Table of Contents

EXECUTIVE SUMMARY ................................................................................................... 1

I.  INTRODUCTION ......................................................................................................... 11

II.  SUMMARY OF PHASE I ANALYSIS ..................................................................... 13

III.  PHASE II ANALYSIS AND RESULTS .................................................................. 15

   A.  Impact on Other State Programs ..................................................................................15

   B.  Impact on the Uninsured ............................................................................................. 19

   C.  Impact on Providers .................................................................................................... 24

   D. Economic Impact ......................................................................................................... 37

   E.  Impact on Commercial Market ....................................................................................41

IV.  METHODOLOGY......................................................................................................... 46

   A.  Impact of ACA on Medicaid DSH Payments ........................................................ 46

   B.  Health Systems ............................................................................................................ 47

   C.  Federally Qualified Health Centers ..............................................................................52

   D.  Community Mental Health Centers ........................................................................55

   E.  Cost-Shifting ...................................................................................................57

   F.   Economic Impact ..........................................................................................................58

I'm sure a lot of what it contains will be duplicated in the Alaska study.  At the very least, comparing the two studies should prove interesting.  How are they the same and how are they different and why?  Because the data are different, or because the instructions are different?