Just do it.
That's the mantra of Alaska Gov. Bill Walker, a Republican turned Independent who has unilaterally decided to expand Medicaid eligibility on his own. Walker will apply to the Centers for Medicare & Medicaid Services (CMS) directly, bypassing the Legislature, which has blocked expansion repeatedly, the New York Times has reported.
"This is the final option for me," Walker said recently at a speech, according to the New York Times. "We are not going to step away from this opportunity to help fellow Alaskans, period."
Walker added that expansion was a common-sense move. Altogether, expansion of Medicaid eligibility would enroll about 44,000 Alaskans, or about 6 percent of the state's total population. Only two other states have expanded Medicaid eligibility through executive order--West Virginia and Kentucky--and only because state law allows it. Walker said enrollments are expected to begin in September.
That would make Alaska the 30th state to expand Medicaid eligibility. Hospitals in those states have reported sharp drops in uncompensated care. Altogether, studies have indicated the Affordable Care Act has helped hospitals avoid some $5.7 billion in uncompensated care costs in the past year, but nearly three-quarters of that benefit is going to hospitals that operate in Medicaid expansion states. According to a letter Walker recently sent to lawmakers, the state was losing $400,000 a day by not expanding Medicaid.
A state's decision to expand Medicaid has been mostly political, and not a new approach to healthcare for poorer populations. The Wall Street Journal noted that about the same number of states that have accepted Medicaid expansion accepted the program 18 months after its inception 50 years ago. But overall, a large majority of the American public believes the Medicaid program is valuable and should be supported.