5 Things Alaska: State budget, Biden transition players, Election results

I have good news for you: there are only 43 days left in 2020. The bad news is that 322 days ago, I was convinced that 2020 couldn’t be worse than 2019.

The lesson is to take a breath. Turn off cable TV and stay off Twitter. Be present. Maybe read Thoreau (h/t Jim Grazko).

Thanksgiving is a week away! And, while it might be a little different this year, we all have so, so much to be thankful for. So, count your blessings. Hug your kids. Call your mom.





With help from Emily Boerger

1. Legislators: “A fork in the road”

Rep. Geran Tarr and Sen. Natasha von Imhof joined us at the 2020 Alaska State of Reform Health Policy Conference last month for a review of the budget situation facing Alaska. Tarr says instead of relying on service cuts or cuts to the PFD, we first need to ask: what investments will reduce the demand for services? She says heading into next year, she will focus on long-term planning on prevention, early interventions, and investments in children and families.

Sen. von Imhof says budget discussions are about choices and philosophy. She points out that in 2019, the legislature declined to invest $4.5 million in a housing pilot, but that year paid out $1.1 billion in dividends. “We can talk about reinvesting all day long and we can give people dividends, but without a house they’re really not having any place to pay rent to,” says von Imhof. “So, we have in our state right now a significant philosophical choice and there’s a fork in the road.”


2. Sen. Murkowski wins re-election

Ok, Sen. Murkowski was not on the 2020 ballot. However, before the 2020 election, the most important statewide election in Alaska was the Republican primary. It was a once-in-a-half-century Republican that can overcome that, or a once-in-a-generation Democratic wave, or maybe a special confluence of personalities and timing. It took something special.

That has all changed. Alaska officially becomes the second state in the nation to allow ranked-choice voting on statewide races. The ballot measure, which passed narrowly by about 3,800 votes, creates an open top four primary. In 2022, it’s reasonable you’ll have 2 or 3 Republicans on the general election ballot. With one Democrat on the ballot, moderate Republican candidates who lose will have their votes go, I’m postulating, to the next most moderate candidate. It will remain hard for Democrats to win, but moderate Republicans, like Sen. Murkowski, are likely to become heavy favorites for statewide office in 2022 under these rules.


3. COVID: Looking 22 days ahead

For the 7th week in a row, Alaska is seeing more new COVID cases (+3,930) than any previous week. The statewide positivity rate is also at a record high for the 7th week in a row and all areas of the state are in the high-alert zone. DHSS predicts cases will continue to accelerate and will double again within the next 39 days or sooner.

A recent analysis out of DHSS finds that two out of three Alaska adults have an underlying health condition – such as diabetes, heart disease, or smoking – that can make COVID-19 more serious. This could signal trouble ahead as hospitalizations continue to reach record levels. A reality baked into these numbers is that 1.8% of each day’s new cases are likely to be listed as deaths in, on average, 22 days.


4. I got COVID. Here is what I learned.

Last month I was diagnosed with COVID. I quarantined in my home office with light but still-worrying symptoms. I thought I was getting ready for a heart attack from the chest tightness before the diagnosis, to be honest. While the disease was jarring, even more disappointing was my experience with the primary care and public health systems. I’ve written before about how good the care was for my uncle when he was 38 days on a ventilator.

But, it’s clear to me now that if you get COVID, you’re mostly on your own. Testing is still a mess in many cases, and varied across communities. Even the protocols don’t seem to make sense. For example, if you come in contact with someone with COVID, but you test negative, the protocol is to quarantine for 14 days. If you test positive, you only need to quarantine for 10 days. I know the reasons why this might be the case still, but the gold standard is two negative tests about five days apart. With more and better testing – even in a state that has been so successful with testing like Alaska — we can dispense with this 14-day requirement and better support people in managing through this crisis.

5. Biden’s transition team for health care

The Biden-Harris transition team took a step forward in preparing for its transition to the White House by announcing the members of its agency review teams last week. While the teams include over 500 individuals who will lead the transitions for each federal agency, it appears at first glance there are no Alaskans on the list.

The Department of Health and Human Services team includes 30 individuals with a broad range of expertise in the health care sector. The team features several Obama administration alums including Manatt Health Managing Director Chiquita Brooks-LaSure and Robert Gordon, Director of the Michigan Department of Health and Human Services, who will both serve as team leads. Also on the list is HMA’s Jon BlumMeena Seshamani, MD, with MedStar Health, and Eliot Fishman with Families USA.