5 Things Alaska: Health in the budget, Broadband report, People First Initiative


Emily Boerger


In case you missed it, on Monday we released the Topical Agenda for the 2022 State of Reform Federal Health Policy Conference. The event is coming up on February 17 and will be fully virtual, allowing attendees from across the country to participate!

This conference will feature conversations on federal health policy, innovations in the state-federal relationship, and learning labs for state-level successes. If you already know you want to join us, be sure to register here.

Emily Boerger
State of Reform


1. Gov’s budget looks to split DHSS again

Gov. Mike Dunleavy’s FY 2023 budget again proposes splitting DHSS into two departments—establishing both a Health Department and a Dept. of Family and Community Services.  Dunleavy offered a similar proposal in 2020, though later withdrew his executive order following pushback from the legislature and concerns about potential technical issues in the order.

Dunleavy’s operating budget proposal includes a combined $3.5 billion for the two departments. For behavioral health, the Dept. of Health operating budget includes $45.5 million in total funds for BH treatment and recovery grants, $9.2 million for BH prevention and early intervention grants, and $675,300 for the Suicide Prevention Council.


2. Dunleavy unveils People First Initiative

Gov. Dunleavy last week also announced a suite of packages aimed at addressing domestic violence and sexual assault, Missing and Murdered Indigenous Persons, human trafficking, foster care, and homelessness. The issues are standalone initiatives, encompassing a mix of statutory changes, budget increments, staffing additions, and administrative actions, according to a press release from the governor’s office.

A primary element of the initiative is the acquisition of a statewide database and management system to spot patterns and identify causes of homelessness, trafficking, and Missing and Murdered Indigenous Persons. The upfront cost of the system is $750,000, with an annual operating cost of $250,000. Dunleavy announced he will propose an omnibus crime bill during the upcoming session which will address many of these same issues.


3. Omicron cases expected to rise, while hospitalizations stay steady

New projections from the Institute for Health Metrics and Evaluation (IHME) anticipate that the omicron variant will lead to the largest wave of COVID-19 infections Alaska has seen, with more than 2,500 daily infections by February. At the same time, it is projecting that daily deaths will continue to hold relatively steady.

Despite the rise in infections, IHME predicts hospital resource use will stay at roughly current levels through March. Alaska is also expected to fare better in terms of ICU bed availability than most other states. The Institute projects less than 10% of ICU beds will be occupied by COVID-19 patients between now and May.

4. Task force calls for an Office of Broadband Deployment

The Governor’s Task Force on Broadband recently released its final report, highlighting a range of recommendations aimed at closing Alaska’s digital divide. Among several recommendations, the task force calls for the streamlining of the state permitting process, the establishment of a federal grant-matching fund, the creation of a Broadband Parity Adjustment, and prioritization of the unserved and underserved.

The task force also recommends that the state create three entities—including an Alaska Office of Broadband Deployment—to continue Alaska’s work expanding broadband access. “Of all U.S. states, Alaska is, by almost any measure, the most challenging place to ensure the ubiquitous delivery of high-quality broadband services,” reads the report. “This is true both in the assessment of broadband needs and the closure of coverage gaps once those needs are identified.”

5. 9.7% increase in US health expenditures in 2020

CMS’s annual report on national health spending found that total health expenditures in the United States reached $4.1 trillion during 2020—a 9.7% increase over the 2019 level of $3.8 trillion. This combined with the overall shrinking of the U.S. economy means national health expenditures (NHE) were equal to 19.7% GDP last year.

The increase was driven by the federal government’s pandemic response, not patients using more services, writes Jim Capretta in his latest column. In Medicaid alone, federal expenditures increased by 19% in 2020. State & local government health spending declined 3.1% compared to 2019. Private business spending on health care also declined 3.1%. The report found there was a net reduction in the number of uninsured Americans, declining from 31.8 million in 2019 to 31.2 million in 2020.