5 Things We’re Watching – Alaska, February 2013

Don’t be fooled by how slow things are this month.  Applications from plans go to the federal exchange next month, and the disruptive potential of the exchange can’t be overstated.  With limited activity in Alaska health policy this month, our eyes are on some of the federal action.

1. Sequestration looms but messages differ about impacts

The latest Congressional brinksmanship – known this time as the “sequester” – has a deadline of Thursday night.  While it appears that the deadline will pass, Congress can still get a deal done in the weeks ahead, likely with limited impacts.  The impacts to healthcare would be meaningful.

Sen. Murkowski offers her insight, noting – importantly – that it’s the uncertainty that is so tough.  But, conservative David Brooks argues both Democrats and Republicans secretly like the situation.

2. Federal exchange efforts get bi-partisan criticism

You think you’re in the dark on exchanges?  Try being a US Senator.  A recent US Senate Finance Committee hearing highlighted bi-partisan and pointed criticism of Gary Cohen, the lead exchange administrator from CMS.

Sen. Orrin Hatch (R-UT):  “We have nearly 600 pages of regulations for the state-based exchanges, but only 19 pages of guidance on the contours of the federal exchange.”  Sen. Maria Cantwell (D-WA):  “You’re trying to lure states on to the exchange (rather than co-ops or the Basic Health Plan Option) because you think it’s some sort of magic.”  Chairman Max Baucus (D-MT):  “I’m a little surprised you don’t know (the agencies involved in the exchange.) You can’t name the others?”


3. Showing the numbers on Medicaid expansion

Hospitals are quietly building the case for Medicaid expansion by shining a light on the financial, economic and fiscal impacts of such a move.

ANTHC released a study this month which said the cumulative economic impact to be $2.49 billion over 6 years.  It also said 3500 new jobs would be created by 2017, and that over a 5 year period, expansion would provide “the state a net positive budget impact.”

4. Early 2014 indications show incumbents doing well

There has been some talk about health care reform being a central issue in statewide races come 2014, and that may well be the case.  But a recent poll shows incumbents with strong positions heading to re-election.

Both Gov. Parnell and Sen. Begich have good favorable/unfavorable ratings: Parnell at 46-44%, Begich with 49-39%.  Head to head in a Senate race it gets interesting, though:  48-48% each.


5. Brokers: when decisions come, they will come quickly

In states hosting a state-level exchange, decisions are only now being made about how brokers will interact with the exchange, and results are mixed.  Some states will force brokers to contract with only the exchange.  Some will require states be contracted with each plan.

The feds have only addressed this question at a very high level.  When the decision comes to Alaska, it’s likely it will come quickly and with limited opportunity for discussion.