5 Things Alaska: Rep. Geran Tarr, Health budget, Jonathan King

Next year will be our tenth year hosting State of Reform in Alaska, and covering health policy with this newsletter.  I can’t really believe we are still at it!  And the primary reason we are is because of you support. You come to our conference, you read our stuff, and you sponsor our work.

So, from all of us at State of Reform, thank you.  We are honored by your support.

Happy holidays to you and your family, and Merry Christmas!



With help from Emily Boerger

and Michael Goldberg.


1. Gov’s budget proposal takes a new approach

Governor Dunleavy released his FY 2021 budget proposals last week, proposing to use Alaska’s Constitutional Budget Reserve (CBR) to balance the budget and keep a full PFD. This new approach is markedly different from last year’s budget proposal where Dunleavy proposed deep spending cuts.

Reporter Emily Boerger breaks down budget changes that impact health and social services. Among the notable changes is an additional $120 million in general funds for Medicaid services in the 2020 supplemental budget proposal, and an additional $27 million in total funds to pay for the newly reinstated Adult Enhanced Dental Program.

2. Q&A with Rep. Geran Tarr

Rep. Geran Tarr serves on the House Health and Social Services Committee. She’s an important voice in the House Majority on health policy and safety net issues. Her Anchorage district is the most diverse legislative district in the country, where the implications of budget cuts play out in real time.

Reporter Michael Goldberg spoke with Rep. Tarr about health legislation in the next session, the ideological divisions that pervade health policy, and the unique qualities of Alaska healthcare. Expect her to be a player in however the House decides to address health and fiscal policy in 2020.

3. AK most improved in annual health rankings report

America’s Health Rankings recently released its 2019 Annual Report, breaking down the state of the nation’s health on a state-by-state basis. Based off measurements covering determinants of health and health outcomes, Alaska ranks 27th overall in the nation and is one of just three states to see a 5-position jump in ranking.

According to the report, Alaska’s improved ranking was driven by jumps in the “behaviors” category where the state saw improvements in obesity and excessive drinking measurements compared to 2018. However, the data shows that Alaska continues to struggle with rates of violent crime (ranked 50th), low immunization rates (50th), and a high uninsured rate (47th). The full data set for Alaska is summarized here.


4. Video: Jonathan King, Halcyon Consulting

Jonathan King is the Founder of Halcyon Consulting, an economic and performance consulting firm. He joins us in this edition of “What They’re Watching” to discuss the intersection between the economy and Medicaid, where he predicts that Medicaid budget cuts in FY2020 may send the state back into recession.

“What makes [the budget cuts] really interesting from a policy perspective is this is the first time we’ve tried to reduce savings not because we’re trying to make the system more efficient, but literally just simply because we want to spend less and we’re willing to give up federal dollars to do it. And that has a big implication for an economy that just spent 3 years losing jobs and right now isn’t really adding a whole lot of jobs. It’s probably enough of an effect to throw the state back into recession.”


5. House passes Lower Drug Costs Now Act

House Democrats laid down an interesting marker in health financing policy with the passage of H.R.3, or the Elijah E. Cummings Lower Drug Costs Now Act. It includes a series of measures that benchmark pricing and limit price increases, with penalties for rate hikes higher than inflation. There are also steep penalties to pharma companies for refusing to negotiate.

Sure, President Trump has promised to veto the bill should it ever reach his desk. But, there will come a time when Democrats again take the majority in both chambers of Congress. It might be next year. It might be next decade. But this legislation shows they are moving strongly into a rate setting methodology for health care. My bet is pharma is unlikely to stop with pharmacy prices.