Alaska governor defies legislature to expand Medicaid

Alaska's independent Gov. Bill Walker put the state on track to become the 30th state to expand Medicaid under the Affordable Care Act. He announced Thursday he would use his executive power to extend eligibility to as many as 40,000 low-income residents.

Walker attempted unsuccessfully to persuade the Alaska Legislature to expand the program, first through the state budget process and then with a freestanding bill. 

"This is the final option for me, I've tried everything else,” Walker said during a news conference. He promised during his campaign last year to expand the program, which helped him beat incumbent Republican Gov. Sean Parnell.

State officials estimate Alaska will draw $1.1 billion in additional federal funds over the next six years under the Affordable Care Act by raising eligibility to residents with incomes up to 138% of the federal poverty level. 

To go around the legislature, Walker is turning to the Legislative Budget and Audit Committee, a group of bipartisan lawmakers that has the authority to review requests for Alaska to accept federal money when the legislature isn't meeting. 

The panel has 45 days to review his proposal. Walker could move forward with the plan even if the committee decides not to support it. 

This mechanism has been employed seven times in the state's history, Walker said. 

The legislature could derail the effort by reconvening during the 45 days, Walker said. 

There's some reason to believe that won't happen.

Governors in Kentucky, Ohio and West Virginia all went around their legislatures to expand Medicaid, and none of those states has subsequently reversed course, according to Laura Snyder, senior policy analyst at the Kaiser Commission on Medicaid and the Uninsured.

Walker is proposing a straightforward expansion rather than pursuing a complex waiver from the CMS like several other conservative-leaning states, such as Indiana and Montana. 

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