Rep. Hawker exclusive | Legal argument against expansion | Topical agenda

There are only 16 days left for LB&A to review Gov. Bill Walker’s decision to expand Medicaid in the state. Though its not clear what action, if any, the legislature will take, we’ve got an exclusive interview with Rep. Mike Hawker, Chair of the Legislative Budget & Audit Committee, with a key window into how this process is unfolding.

Wondering what’s coming next?  Our Oct. 8 conference is the place to be with a Topical Agenda you won’t want to miss.

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1. Exclusive: Interview with Rep. Hawker

Rep. Mike Hawker, Chair of the Legislative Budget & Audit Committee, reached out to us after reading the last edition of 5 Things We’re Watching. With all of the different opinions on what the legislature should be doing, he wanted to make sure everyone was clear about what his committee could actually do.

In a State of Reform exclusive interview, Rep.Hawker speaks candidly about LB&A’s role in the proceedings and explains how silence from the committee may be the best strategy for those who oppose expansion. He also tells an interesting story of how the Governor formally “notified” him this was coming.


2. Check out our Topical Agenda for Oct. 8th!

If you haven’t already, mark your calendars for Oct. 8 when health care executives and policy leaders from across the state will gather at the Dena’ina Convention Center in Anchorage. The early birds of Alaska have already purchased their tickets, but it is not too late to secure your spot in what has been called “the most important health care event of the year!”

You can check out our Topical Agenda, here for an overview of what you can expect.  We’re recruiting speakers now, and will have more than 60 when we’re all done. Stay tuned for our Detailed Agenda to be released in the next two weeks with a list of everyone you can expect to hear from!


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3.  Blowback begins on Walker

Legislators’ initial reaction to Governor Walker’s expansion move was decidedly cautious. But since then battle lines have begun to form. Among the protests are legal issues, economic theory, and expansion’s potential impact on Alaska’s fiscal crisis.

It’s unclear whether or not there is enough support in the legislature to bring a special session together to block the Governor’s move. Some members of Alaska’s largely Republican legislative majority are publicly supportive of expansion, and the Governor taking unilateral action to implement it.


4. Providence granted Certificate of Need

In the Spring, Providence Alaska Medical Center (PAMC) filed an injunction against the state and countered Alaska Regional Hospital’s CoN application for emergency departments in Eagle River and South Anchorage with its own application for 14 additional ED rooms. In mid-July, the Commissioner granted that certificate to Providence over Alaska Regional. Providence will get eight ED treatment rooms in Anchorage with a project budget capped at $12.8m, according to the CoN.

This was a big win for Providence in a public campaign that appeared to highlight a somewhat mismanaged process by the state. It’s added to the buzz that the next session will have a significant legislative effort at rolling back CoN regulations – something I’m sure many hospitals would support.


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5.  Door open for legal challenge to expansion

With less than three weeks until Walker’s September 1st implementation date, opponents are calling for a challenge to the Governor’s move. Indeed, the legislature’s own lawyers believe a court ruling is the only way to be certain that the Governor is within his authority.

Early opinions appeared to put Governor Walker’s Medicaid expansion on solid legal ground. But opponents are beginning to chip away at the foundation. At issue is whether or not Medicaid expansion is a new program, and whether it is mandatory or optional for states to implement. Federal statute says it is mandatory. However, the Court’s ruling was that expansion constituted a new program, which opponents say is “optional” by definition.