So as you all may know, Alaska is broke. Perhaps I could put that more lightly and say the state is having some budget issues. Unfortunately, health care hasn't escaped the pinch of the state's lightened bank account unscathed. Namely, Medicaid seems to have found itself on the back burner of the budget.
If you're not familiar with Medicaid, no need to be embarrassed. In fact, take a moment to educate yourself on the largest source of health care coverage in America. The following is the CliffsNotes definition of Medicaid from the State Department of Public Assistance website;
Medicaid, an entitlement program created by the federal government, is the primary public program for financing basic health and long-term care services for low-income Alaskans. It is funded by federal and state general funds. The program focuses on coverage for low-income children, pregnant women, families, adults without dependent children between the ages of 19 and 64, the elderly, blind and the permanently disabled.
Today, more than 200,000 Alaskans are covered by Medicaid, up more than 60 percent from the 2015 figure. A large part of that was Gov. Walker widening the low-income eligibility requirements in 2015 after the introduction of the Affordable Care Act. That action, paired with Alaska having the highest unemployment rates in the country at nearly twice the national average, does not a winning formula make.
Early in 2018, the Governor's Administration was seeking about $93 Million to cover Medicaid until July 1st, the start of the new fiscal year. They were given $45 Million in March via fast track supplemental funding, with the additional to come in the capitol budget. That $45 Million has been exhausted, and the remaining $48 Million is not in the budget, which means there will be stoppage in payments to hospitals.
And it's not like this is a situation where you can float the boat with cash from elsewhere. Like most small hospitals, nearly half of WMC's revenue comes from Medicaid. And even when WMC is being reimbursed, it's coming in at less than it costs to provide the service. Imagine trying to run a business where half of your customers are paying you less than you paid for the product. Now imagine that same half of your customer base no longer having the money to shop at all. Small hospitals defy the logic of a typical business plan.
Critical access hospitals like WMC are in some risky waters. It's no secret that shrinking reimbursements and operational costs, including upkeep on an aging facility, have continually had WMC in the less-than-30-days-cash-on-hand zone. Take away Medicaid and there's no more cash on hand. Alaska State Hospital and Nursing Home Association (ASHNHA) President Becky Hultberg outlined the situation in her March 2nd letter to the State Senate, which can be read below (click the letter for a printable version).
Keep tabs on the state budget and the Medicaid situation, as quite a bit of news could unfold in the coming days/weeks. Google News has been full of articles as of late. Catch the ear of a representative, if you get the opportunity. For some great info and figures on the state budget, check this presentation from the ASHNHA OMB. It's understandable that cuts must be made given the state financial situation, but it's scary to think that those cuts could include the health and wellness of Alaskans.