5 Things Alaska: Benefits of CSR cuts, Al Wall, Alaska Common Ground

We are still coming down from hanging out with 300 of our closest friends in Alaska health care two weeks ago at our 2017 Alaska State of Reform Health Policy Conference.  It was a great event, and I think it captured a new level of energy, enthusiasm and – dare I say – optimism!

Perhaps that optimism pervades our newsletter this month, but I think there are silver linings in a number of the things we’re watching in Alaska health care in October.

DJ 5 Things Signature


1.  6 steps to understanding the benefits of Trump’s cuts of CSR funding

There are a lot of politics involved in Trump’s CSR (cost-sharing reduction payments) decision, and reasons to be concerned about it as a result of those political considerations. This is particularly true for plans that now have to eat three months of plan year 2017 without the estimated $1.75 billion in CSR payments that would have come over the last three months.

However, there’s more to this story.  Ever the contrarian, I lay out a six-step approach to understanding some very real benefits to consumers, to health plans and the insurance market as a whole. Alaska Director of Insurance also argues that the impact to Alaska health care would be limited.

If you want an actuary’s take instead of mine, read this. “Insurers will actually receive more federal money if the CSRs are not funded… Overall, these dynamics should lower the uninsured rate as APTC eligible individuals have a larger price incentive to seek coverage and more individuals have free coverage options.”


2.  What you missed at State of Reform

Two weeks ago, we hosted almost 300 folks at our 2017 Alaska State of Reform Health Policy Conference. It was a great crowd, and perhaps the most dynamic, jam-packed conference we’ve hosted since launching in Anchorage in 2011.  If you weren’t there, you can see what you missed here.

US Sen. Dan Sullivan’s remarks opened our conference, and Director of Insurance, Lori Wing-Heier, provided comments to close our day’s agenda.  In between, I moderated a panel of some of Alaska’s most important health and fiscal policy voices in a conversation that was candid, energetic, and dynamic.  We’ve posted the presentations that we received here so you can scan through them to see even more of what you might have missed.



3.  Video: Al Wall, CEO of Peninsula Community Health Services

Al Wall joined us for our latest episode of “What They’re Watching.” He runs an FQHC now, and previously served as the Director of Behavioral Health for the State of Alaska.  So, he has a perspective that runs across both the public and private sectors.  He’s also candid in a way that is refreshing.

“One of the things that I really like about Alaska is that we have the stability, not just to pull ourselves up by our bootstraps, but sometimes we get a little tired of waiting for other people to do something for us. We just decide to do it ourselves. And there are pockets around the state of Alaska right now where kind of grassroots movements are doing tremendous things.”



4.  “Me, too” in Alaska

This weekend’s organic and viral “Me, too” campaign to show how broad sexual assault and harassment is among women. Alyssa Milano’s simple post on social media Sunday morning has been credited with launching over 6 million Facebook posts in 24 hours.

In Alaska, sexual assault is three times higher than the national average. It’s six times higher for children. “One out of every three American Indian and Alaska Native women will be raped during her life, and three out of every four American Indian and Alaska Native women will be physically assaulted.” Anchorage and Fairbanks have been the US cities with the highest rates of rape.  Gov. Parnell highlighted this issue as a central focus during his time in office, to his distinct credit. I recall presentations where he would suggest some villages had rates of sexual assault that approached 100%. He conveyed that some of the elderly village women called this “a rite of passage.”

To those of you brave enough to tell your story, whether in long form or in two words, to the authorities or to people that love you, thank you for your courage.  I believe you.



5.  Four events focused on health care costs

Alaska Common Ground is a community-centered organization with a mission “to build understanding in order to work toward building a consensus among people who hold diverse points of view while respecting differences in opinion.”  It’s the kind of organization that tends to focus on unique-to-Alaska issues facing the community, like urban-rural relationships, “cost effective justice,” or ethics in the hopes of supporting a broader dialog.

So, that they’ve planned four upcoming events featuring health care costs as an organizing topic is noteworthy.  It’s a demonstration of the popular response to higher health care costs in the face of increasing economic insecurity. And, as events like these inform community voices, it makes any fiscal solution to Alaska’s budget more likely to need to address deeper health care reforms.