Alaska Governor Bill Walker announced today that he’s taking executive action to expand Medicaid as soon as September 1, making Alaska the 29th state (plus the District of Columbia) to take the expansion under health reform. That’s good news for the 40,000 Alaskans who will become eligible for Medicaid. It’s also good news for the state budget because it will save as much as $6 million in state costs this fiscal year.
Moreover, Alaska will start realizing these coverage gains and budget savings immediately by expanding coverage under standard Medicaid rules, bucking the recent trend of states implementing the expansion through a federal waiver.
All but five states that have adopted the Medicaid expansion (which makes coverage available to adults making less than 138 percent of the poverty line) have done so without a waiver. But the expansion debate across the country recently has mainly involved states considering a waiver, which gives states more flexibility over their programs. The Administration has approved waivers for Arkansas, Indiana, Iowa, Michigan, and New Hampshire, while Montana lawmakers have directed the state to pursue a waiver and Utah lawmakers are considering one.
Expanding through a waiver, however, takes time. States must decide what their proposal should include, solicit public comment on it, and then negotiate with the federal government over the terms. In the meantime, states miss out on the demonstrated benefits of expansion, from expanded health coverage to budget savings. By opting for a “straight” expansion, Alaska can glean the benefits of the expansion without delay.