Brad KeithleyDave ... Nope, went to the fiscal responsibility school of government. Medicaid is now the second largest category of state spending behind, and on a faster trajectory of growth than even, K-12. Alaska has opted into more optional services than any other state, has the highest medicaid reimbursement rates of any other state (and, along with Wyoming, is only one of two states where Medicaid reimbursement rates exceed Medicare) and has the highest qualifying criteria (in terms of percent of the poverty rate, sometimes in excess 200%) of any state. By repeatedly using the justification of "the federal government will pay most of the costs," Alaska has worked its way into a position where Medicaid costs now are eating away at the state's ability to continue to fund K-12, the University system, police, corrections and any number of other programs. In order to avoid crashing other programs Medicaid needs to be reformed, not added to. Once we achieve reform there may well be room for adopting expansion, but until then there isn't any room remaining in Alaska's fiscal structure.
The full exchange, which started with my concern about recent votes by three legislators and what that means for where things may be headed on Medicaid expansion is here.