Posted by: shannynmoore | December 21, 2013

Parnell’s Medicaid decision driven by politics, not welfare

Shannyn Moore for the Anchorage Daily News

We all have our go-to folks. When I need advice, I go to someone who knows the subject, has my best interest at heart, but will tell it to me straight, even if it’s not what I want to hear.

Gov. Sean Parnell, who recently decided not to help 41,000 Alaskans get access to affordable health care, has a very different approach.

When the Affordable Care Act was being debated nationally, people in Washington could see there were Americans who were going to fall through the cracks. They were the workers who made too much money to qualify for Medicaid coverage for the poor, but didn’t get insurance from their jobs and couldn’t afford to buy their own. We call these the working poor — people who live at 101 to 133 percent of the federal poverty level.

Here’s the kicker. These are people who work hard for a living. Not only do they have jobs, many of them have more than one job. They aren’t the “sitting-on-their-tails-doing-nothing takers” of Mitt Romney’s nightmares. These are people who, if they really need significant health care, have to quit their jobs and let the government pay for it.

So the ACA required states, with much federal help, to expand their Medicaid programs to cover these working poor.

Last year, the U.S. Supreme Court upheld the constitutionality of the ACA, but decided that states couldn’t be forced to broaden their Medicaid programs to cover the working poor.

Why would states not want to cover low-income earners? Healthy workers are more productive. They don’t show up in emergency rooms needing “free” care. And of course the sweetener remained. The federal government would pay for the expansion and continue to pay 90 percent even after 2020.

The idea that any state — but especially Alaska — would turn down federal money today because it might not be there tomorrow was preposterous.

Now, back to where we go for advice.

As reported in this paper, “Parnell told reporters … he made (his decision) after reviewing an $80,000 state-commissioned study by a Falls Church, Va., health care consultant, The Lewin Group.”

The Lewin Group’s advice to Parnell? Don’t expand Medicaid coverage.

The report was 60 pages — so we paid about $1,300 a page. What was remarkable about the report was how closely it resembled a similar report the Lewin Group had already prepared for New Hampshire. (I mean similar like the book report that gets turned in for 10th and 11th grade English class.)

You may recall that this was the report the governor refuse to let any of us see until the day he announced his Medicaid decision.

That decision rejected the recommendations of the Anchorage and Alaska chambers of commerce, AARP Alaska, the Anchorage NAACP, the Alaska Federation of Natives, the Alaska Native Tribal Health Consortium, the Anchorage Faith and Action-Congregations Together and others.

Instead he took the advice of The Lewin Group.

Thoughtful Alaskans are still shaking their heads in wonder.

Why would the governor dismiss the counsel of so many Alaskans for the recycled advice of these particular consultants?

According to the Columbia Journalism Review, which scolded journalists in 2009 for reporting the Lewin Group’s talking points without explaining the company’s background:

“(Lewin Group is) part of Ingenix, which is owned by United Healthcare Group, the insurance behemoth that has been buying up insurance companies left and right, expanding its reach into just about every segment of the health insurance market. Its flagship, UnitedHealthcare, helps make it the largest health insurer in the country. It’s a safe bet that United is not too keen on a public (health care) plan that might shrink its business.”

Now you might think, “Our governor is just a naive country boy. He didn’t realize he was asking the health insurance industry for advice about whether the state should use federal money to insure poor, working Alaskans.”

But if you didn’t just fall off a turnip truck, you’re probably thinking, “The governor wants the ACA to fail. He was willing to throw 41,000 Alaskans under the bus to help that happen. He bought the Lewin Group report because he knew they’d deliver the opinion he wanted, and he needed it as a fig leaf to cover a cynical, political decision.”

If you’re concerned about waste and fraud in government, this is a perfect example of what it looks like: the Lewin Group report and Sean Parnell.

Shannyn Moore is a radio host on 1480 AM in Washington, D.C., and Netroots Radio

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