Gov. Bill Walker hints at special session if lawmakers don't address Medicaid expansion


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JUNEAU, Alaska — Gov. Bill Walker on Thursday hinted at a possible special session if legislators don't act on Medicaid expansion before the session's scheduled end on Sunday.

"If they run out of time and it's not been addressed and they don't extend their own time to address that, then we'll put more time on the clock," he told reporters Thursday.

He said he would be inclined to have a special session immediately after the regular session if one is held but would want to discuss that with legislative leaders.

Walker has called Medicaid expansion a must-have, but some members of the Republican-led House and Senate majorities say they have concerns with adding thousands more people to a system they see as broken. Some say they want to see reforms enacted, and how those are working, before moving toward expansion. The state health department has said it has reform efforts underway that could save the state about $240 million over the next six years.

Rallies in support of Walker's plans to expand and make changes to Medicaid were planned in communities across Alaska Thursday, with Walker taking part in one on the Capitol steps.

Bills dealing solely with reforms also are pending. A version of one of those bills, which passed out of Senate State Affairs on Thursday, would require legislative approval before the health department adds people to Medicaid. Health commissioner Valerie Davidson told the committee this week that she objected strongly to the provision.

Walker said this week that he couldn't support Medicaid reform legislation without expansion. Supporters say it would allow the state to leverage federal funds to help finance reform efforts. For states accepting expansion, the federal government is to pay the health care costs of newly eligible recipients through 2016, stepping down to 90 percent by 2020.

Skeptical legislators worry that federal funds won't be there in the future, leaving the state to pay for the program.

The Walker administration has said it wouldn't participate in expansion if the threshold fell below 90 percent.

Concerns persist, too, among some lawmakers about the Medicaid payment system, which was plagued by problems following its 2013 launch. The state last year filed a complaint against the vendor hired to implement the system, saying there were pricing errors and that providers were being paid when they shouldn't.

A department official, Sana Efird, told the House Finance Committee this week that there have been "great improvements" to the system since an audit review last year.

It will probably take until September to reprocess all the claims that were paid, denied, or suspended inappropriately, department spokeswoman Sarana Schell said by email.

Sen. Cathy Giessel, R-Anchorage, said she wants to see the data to back up statements on the changes that have been made.

Rep. Steve Thompson, R-Fairbanks, and co-chair of the House Finance Committee, said adding people to a system that isn't working properly could hurt the state.

"We've got to be careful that we have things that are going to work before we start adding 20,000 to 40,000 people to a system that's broken," he said.

A report commissioned by the department estimated that about 42,000 people would be eligible for Medicaid in fiscal year 2016 if the state opts for expansion and that about 20,000 would enroll that first year.

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