5 Things We’re Watching – Alaska, December 2012

The events in Newtown, Connecticut, are a good reminder of what’s important in our lives, and why we all – me, you, our colleagues – do this work:  to improve the lives of our friends, neighbors and families.

So, in this holiday season, with a renewed perspective afforded to us all, I want to say thank you – for everything you’re doing, in big ways and small, noticed and overlooked.

Your effort matters.

1. Update on the “fiscal cliff”

In the last month, I’ve been in DC twice making the rounds on “fiscal cliff” matters.  Keep your eye on two key players.

Eric Cantor, the #2 House Republican with an eye on the top job, has been very quiet.  Some members think he is waiting to see if a coup in House Republican leadership is possible by scuttling any deal. Recent news, however, may challenge that theory.

Patty Murray, incoming Senate Budget Chair and Democrat from Washington, has quietly but effectively been making the case to go over the cliff.  She’d rather vote for middle-class tax cuts in January than vote to hold down taxes for everyone in December.

2. Mental health: elevated in the national discussion

The careful national discussion following the massacre in Newtown, Connecticut – including the NRA committing to “meaningful contributions” to the debate – has allowed for an elevated focus on mental health in America.

The embodiment of this is this mother’s powerful narrative which quickly went viral this week.

On this, Alaska is both a leader and a laggard. It boasts a Baldrige Award-winning model for care integration.  According to one study, it also has sustained (from 2009 to 2011) the largest cuts to mental health spending of any state, during the period of greatest cumulative state cuts since 1963.

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3. Changing the frame in the Medicaid discussion?

It’s hard to know with certainty what the future of Medicaid looks like in Alaska.  But, we picked up on a subtle shift in how Gov. Parnell appears to be approaching the topic.

Where we used to hear about “serious concerns” regarding expansion from Gov. Parnell, now we see his administration – while still “skeptical” – is “entering into negotiations with providers.”  That seems like a noteworthy shift.

4. The Governor’s budget

Governor Parnell released his budget this week which pares back overall state spending by about $1bn.  The Dept of Health and Social Services budget has a modest growth of 0.7%.

Behavioral health grants are cut significantly (20.9%).  Adult dental services get a large increase in funds (31.0%).  Foster care funds for kids with special needs (26.3%) and infant learning program grants (22.1%) also get healthy percentage increases.

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5. The federal exchange, as negotiated

Now that the deadline has passed for states to choose to run their own exchanges, it’s clear that over 30 states will leave the task to the federal government.  This seems a clear vindication for Gov. Parnell’s early opposition to a state-led exchange.

The feds appear to have been caught a little flat-footed on the scope of the rejection.  This gives states some new leverage in an unfolding negotiation between governors and the White House regarding what the federal exchanges will look like.