Medicaid Expansion Hurts Medicare Seniors and Tricare Families

Who will lose from Medicaid expansion in Alaska? Seniors and veterans' families, that's who.

This is a reprint of an article we posted on April 14, 2015.

An open Letter to Governor Walker and Alaska State Legislators

Of all the issues surrounding Medicaid expansion, fairness to Alaska’s senior and veteran populations should be the highest priority. The expansion of Medicaid will have a very serious adverse impact on Medicare seniors, and veterans and their families enrolled in Tricare, the HMO for military retirees and active duty families.

As you may be aware, the government reimburses a primary care health care provider about 30 percent more to see a Medicaid patient than to see a Medicare patient. The government also reimburses a primary health care provider more to see a Medicaid patient than to see a Tricare patient.  The senior on Medicare has paid into the Medicare system every working day of his/her life.  Once enrolled into Medicare, that same senior pays a minimum of $105 per month for outpatient care (Part B).  The Medicaid patient, on the other hand, pays nothing into the system. Is that fair?

Similarly, the veteran pays into the Tricare system as a benefit for service to his/her Country.  In the case of a veteran returning from Afghanistan that has lost a limb, that veteran’s family will take a back seat to the person enrolled in Medicaid because of the lower reimbursement.  Is that fair?

There is already a serious shortage of primary care providers in Anchorage.  An ISER report, dated June 2012, noted there were only 13 primary care providers in Anchorage who would see new Medicare patients.  And the same ISER report stated that there were 20,000 seniors living in Anchorage.  Health care for Medicare seniors will only get worse with Medicaid expansion.

I understand that much of the Medicaid funds will be used by patients for transportation from rural Alaska to see a healthcare provider in Anchorage.  Medicare and Tricare do not pay seniors or veterans’ families to travel say from Talkeetna to Anchorage to see a physician.  Why then should a Medicaid patient be paid for travel to Anchorage?  Neither Medicare nor Tricare pay lodging and meals like Medicaid does.  Is that fair?

I have heard the Administration’s argument that taking “federal” dollars will create some 4,000 jobs.  I personally do not see doctors, physicians, and nurse practitioners flocking to Alaska because the State has expanded Medicaid.  Most of these jobs will be administrative overhead, not health care providers.  Just more of the same bureaucracy.

This is a question of fairness. Seniors and veterans have paid into the health care system both financially and some with their lives.  Why should both seniors and veterans take a very high number in the doctor’s office now?  Remember, both seniors and veterans are super voters.  And 17 percent of Alaskans are veterans; according to the Alaska Department of Labor & Workforce Development, there will be more than 85,000 seniors in Alaska by 2017.

There are many special interests who stand to gain from Medicaid expansion.  They know who they are.  But seniors and veterans stand to lose from Medicaid expansion.   Legislators and Governor Walker, do you know who they are?

Finally, to quote Commissioner Davidson when asked by the media if the State could opt out of Medicaid expansion once it was expanded: “There are no guarantees in life”.

This is a question of fairness.   This is about our seniors and veterans.