As long as the Alaska legislature wants to keep the massive Medicaid expansion enacted under the Affordable Care Act Republican Sen. Lisa Murkowski won't vote to repeal it. However, there is little doubt that the Alaska state legislature did not want the Medicaid expansion in the first place, and it's unclear whether they still want it at all.
During Murkowski's annual address to the Alaska legislature Wednesday evening, she addressed concerns about Republicans' plan to dismantle the controversial Affordable Care Act and promised to vote according to her state's wishes when it comes to Medicaid and Planned Parenthood.
"Here in Alaska, some 27,000 Alaskans — about 28,000 actually — now have coverage for the first time," Murkowski said. "Which means that they have access to care for the first time. While I clearly have concerns about the expansion's long-term costs, it has strengthened our native health system and reduced the number of uninsured that are coming into our emergency rooms."
She added, "So as long as this legislature wants to keep the expansion, Alaska should have that option. So I will not vote to repeal it."
According to the Alaska Dispatch News, the state's expanded Medicaid program was enacted by Gov. Bill Walker (I) in 2015. And while the federal government covered the full costs of the program through 2016 — and will scale back to covering 90 percent of the program through 2020 — the state legislature has not yet voted to support or kill expanded Medicaid.
However, Walker unilaterally expanded Medicaid in his state after the state legislature refused to pass it.
"This is the final option for me," Walker said at the time after not getting the legislature's support. "We are not going to step away from this opportunity to help fellow Alaskans, period."
Through its Legislative Council, the Alaska legislature in turn sued Walker, challenging his expansion of Medicaid. The lawsuit was dropped in June as the legislature declined to appeal after it lost in the Superior Court in Anchorage.
Governor Bill Walker threatened in 2015 to veto any reform to Medicaid that did not expand the program, so any such measure introduced by the legislature would likely fail.
The Alaska Dispatch News reported that total payments under the expanded Medicaid program totaled $350 million through the end of last month.
As part of Republicans' move to completely revamp former President Barack Obama's controversial health care law, the vast expansion of Medicaid, the nation's largest insurance program, is on the chopping block. And with no concrete plan in place, Republicans are struggling to figure out just how to curtail Medicaid as millions of people in a majority of states became covered under its expansion.
According to CNN, congressional Republicans have enlisted the help of certain governors to figure out what to do with Medicaid.
"We should be looking to what our state wants to do with the Medicaid expansion," Murkowski told reporters following her address. "And that's why we're looking to the governors for advice."
On Wednesday, Murkowski also said that she would not vote to defund Planned Parenthood, the nation's leading abortion provider, so as to not deny women in her state access to the other health services Planned Parenthood provides.
"I, for one, do not believe that Planned Parenthood has any place in our deliberations on the Affordable Care Act," she said. "Taxpayer dollars should not be used to pay for abortions, but I will not vote to deny Alaskans access to the health services that Planned Parenthood provides."
"On the whole discussion again about repeal and replace, I know that this has been a subject of concern and anxiety for many, but I think most of you who know me, know that I will not support a reckless repeal process that leaves people hanging," Murkowski said. "Repeal must come along with a replacement that reforms and improves health care, that expands access, improves affordability and provides the flexibility that Alaska needs to develop our solutions."
Murkowski said she considers healthcare to be an "area where Alaskans must take greater control over [their] own future."
The Affordable Care Act, quite honestly, has failed to deliver affordable care to many people in our state. Too many Alaskans are facing crushing premium hikes. All but one insurer has withdrawn from the marketplace. And unfortunately if you are part of the individual market, things are getting worse and not better.
And when we talk about the Affordable Care Act and where we go next, what we do, in the conversations that I am a part of and in the conversations that I am leading, I am insisting that there are elements of the ACA that must be saved, that must be preserved.
For example, we must continue to prohibit insurers from discriminating against pre-existing conditions. We must retain mental health parity. And we must allow those under 26 to remain on their parents’ insurance.