Alaska legislators predict dire effects if Congress cuts Medicaid funding
Rep. Genevieve Mina, D-Anchorage, speaks in favor of a budget amendment on Thursday, April 6, 2023, in the Alaska House of Representatives. (Photo by James Brooks/Alaska Beacon)
A budget resolution passed late Tuesday by the U.S. House of Representatives is sparking concern in Alaska, worrying state legislators who say it will lead to steep state budget deficits and tens of thousands of Alaskans without health care.
'That vote is insane,' said Rep. Zack Fields, D-Anchorage.
The House's resolution is the first step toward a budget plan that calls for $4.5 trillion in tax cuts and $2 trillion less in federal spending over a decade. Alaska Congressman Nick Begich III joined fellow Republicans in support of the resolution, which passed 217-215.
Within the resolution is a directive that the House Committee on Energy and Commerce cut $880 billion over 10 years from the section of the federal budget it oversees.
That section includes Medicare, Medicaid, and some smaller programs. But as a New York Times analysis showed, even if the committee were to cut everything that isn't health care in its section, it would still be more than $600 billion short of its goal.
'The only place those cuts can come is from Medicaid,' said Senate Majority Leader Cathy Giessel, R-Anchorage.
Medicaid, a joint federal-state program, is the primary form of health coverage for lower-income Americans and the largest payment source for long-term nursing care
The resolution is only the first step in the budget process — the Senate will need to agree with the resolution, then Congress will have to draft and pass legislation to implement it — but the sheer size of the cuts make it all but certain that Medicaid and Medicare will be affected if the resolution advances in its present form.
That's a big deal for Alaska, where one-third of all residents receive health care through Medicaid. Medicaid payments fund hospitals, clinics and pharmacies, and 12% of all jobs in the state are related to health care.
'Seven in nine Alaskan seniors in our nursing homes are on Medicaid. Medicaid helps seniors and disabilities live independently, and it also strengthens our tribal health system and ensures that there's health care access in rural Alaska,' said Rep. Genevieve Mina, D-Anchorage and chair of the House Health and Social Services Committee.
Alaska is spending $2.8 billion per year on Medicaid, according to the budget enacted last spring by the Legislature and Gov. Mike Dunleavy. About $2.1 billion of that total is paid for by the federal government, and the state contributes about $730 million.
Speaking on the Senate floor, Giessel — a licensed nurse — advised her colleagues to pay attention.
'We need to be aware of this as we consider our budgets,' she said.
Mina, speaking on the House floor, said, 'these current cuts risk creating an at least $115 million hole in our state budget.'
Rep. Andy Josephson, D-Anchorage, suggested that the state could lose $1.15 billion in federal funding, 'and that as many as 60,000 Alaskans — and I suspect more — would fall off the rolls.'
'So I have a request — and that is to our senators, because our congressman has already begun the process of adopting this policy — and my request to our U.S. senators is, don't forget Alaska. Don't forget Alaska,' Josephson said.
Earlier this month, Begich spoke to the Legislature in support of work requirements for federal aid. This week, Mina said that if the congressional budget proposal includes those requirements, the state should be prepared to spend more in order to implement those requirements.
She predicted dire consequences if Congress goes forward with the planned cuts.
'We are going to be hearing a lot from seniors and from people with disabilities and from a lot of working people who rely on Medicaid. And it is not an exaggeration to say that these cuts would cut a lot of people and push them into medical bankruptcy,' Mina said. 'It will worsen our health care options drastically. It will really destroy our own state budget, and it will cause a collapse in our health care system.'
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