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Lawmakers vote to challenge governor on his plan to expand Medicaid in Alaska

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JUNEAU, Alaska — A committee of House and Senate lawmakers voted Tuesday to sue Gov. Bill Walker over his effort to expand Medicaid in Alaska, with Republican legislative leaders calling it a separation-of-powers issue.

The Legislative Council vote followed a closed-door executive session in Anchorage. The vote was 10-1, with Rep. Sam Kito III, D-Juneau, dissenting.

Walker called the council's actions disappointing and said he is not wavering in his position.

Walker moved to expand Medicaid coverage to people ages 19 to 64 who are not caring for dependent children, not disabled and not pregnant, and who earn up to 138 percent of the federal poverty level.

Questions, however, were raised about whether the population that would be covered by the expansion represents a mandatory group for health insurance coverage or an optional group.

The federal health care law expanded eligibility for Medicaid, but the U.S. Supreme Court in 2012 said states could not be penalized for not participating in expanding the program.

Some read the court's decision as meaning that expansion is optional and that legislative approval therefore would be needed to expand Medicaid to a new group of people. It is that view that will serve as an underpinning for the legal challenge.

"We feel that we must first pass a law that allows for the state to do Medicaid expansion," Senate President Kevin Meyer, R-Anchorage, said during a news conference Tuesday.

The potential financial risk to the state from expanding Medicaid is great, Meyer said, though he and other Republican legislators said the decision to sue was about the process, not the policy.

State Attorney General Craig Richards, in a July 31 letter to Senate Majority Leader John Coghill, said the Supreme Court didn't strike down the provision to expand eligibility for Medicaid, but it instead struck down the penalty for states that do not comply with it.

"Just because there is no enforcement mechanism does not change the language of federal law or the language of state law," Richards wrote. "Because Alaska statutes authorize Medicaid coverage for all people who fall under the 'required' category in federal law, Alaska statutes already authorize coverage for this new group of potential Medicaid beneficiaries."

Richards was responding to an op-ed piece by Coghill, a North Pole Republican, calling on Walker to explain why his actions do not violate state law related to legislative approval for additional groups.

Coghill said Tuesday that he thinks the Legislature is on "good, solid ground." He said it's unfortunate that the issue has gotten to this level, "but I think it's important for us to back up our statutes and make the case."

Last month, Walker announced plans to move ahead on his own and accept federal funds to expand Medicaid after lawmakers had earlier tabled his expansion legislation for further review.

Some legislators said they were concerned about adding thousands more people to a system they see as broken. Administration officials have acknowledged the current Medicaid program is not sustainable but see expansion as a way to get federal dollars to help finance efforts to contain and curb program costs.

State law spells out a process by which a governor goes through the Legislative Budget and Audit Committee when seeking to spend more in federal or other funds on a budget item than allocated by the Legislature.

Once the plans are submitted, the law lays out a 45-day waiting period for the governor to move ahead, unless the committee earlier recommends the state proceed. Even if the panel disagrees, a governor can proceed with his plans.

The administration submitted its plans July 16 and has targeted Sept. 1 for the rollout of the Medicaid expansion. Walker plans to move ahead with that timeline unless barred from doing so by a court.

The Legislative Council authorized contracts for up to $450,000 for outside counsel to help with the lawsuit. Walker said the administration may have to hire outside counsel as well, given reductions in the state Department of Law amid budget cuts. The dispute could end up costing $1 million, he said.

Senate Minority Leader Berta Gardner, D-Anchorage, said in a statement that Alaskans want Medicaid expansion. "Elected officials wasting time and money on lawsuits to fight against the wishes and needs of Alaskans makes no sense to me, and I'm confident Alaskans will see it for the political grandstanding it is," she said.

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