On March 1, Gov. Mike Dunleavy sent a letter to President Donald Trump in which he said, among other things: “Your Medicaid administrator, Seema Verma, has urged us to be the first state to receive Medicaid dollars as a block grant. We are eager to do this, but your support of her on this ‘first’ will keep the proper focus and speed on the application.”
After the letter became public knowledge, KTOO did a news story on April 3, saying that Alaska wants to be the first state in the nation to get a block grant for Medicaid, which would mean a reduction in federal funds because the program would be capped with a fixed funding level.
Ten days after that news story, Health Commissioner Adam Crum appeared before a legislative committee and said the state is not pursuing a block grant for Medicaid. He also said he had no involvement with Dunleavy’s decision to promote block grants in the letter to Trump.
Discussing the block grant idea, Rep. Ivy Spohnholz said the state has 79,000 more people on Medicaid than four years ago and the cost to the state is 11 percent lower, with the federal government picking up a bigger share.
“You’re proposing that we move to block grants and that Alaska be the first state in the nation to do that,” she said to Crum at a recent hearing. “Historically, block grants have not worked very well for large, geographically large but small population states. Do you have any hesitation at all about Alaska playing the role of guinea pig as it relates to being the first in the nation to do block grants?”
Crum, whose main experience before his state job was with his family-owned truck-driving and construction academy, said the state wants to be first but not necessarily with a block grant system.
“The idea on that was to let them know that we wanted to be out in front, whatever these solutions were,” he said. “There were some statements from me that were in the media and the last line always gets cut off. Because we did that ask, we are actually now working on any other possible solution.”
“It was a foot in the door, let us be first on something, we need an Alaska-specific solution,” he said.
He said block grants are “not our main plan.”
There is no reason why Alaska should volunteer to go first with major changes to a complex system that would impact the daily lives of hundreds of thousands of Alaskans. This zigzag approach to health issues is beyond foolish.
To top things off, Rep. Tiffany Zulkosky asked what role Crum had in the discussions that led to Dunleavy’s letter to Trump hyping block grants. Since Crum holds the most important job in state government related to health care, he must have had a big say in the policy? Right?
Crum didn’t directly answer her question at first, but instead talked about the coverage of the famous letter to Trump.
“It’s gotten a lot of attention, hasn’t it? And it showed that Alaska wants to be on the front side. So we’ve actually determined and driven a lot of conversations that way. So how can we actually do this on an Alaska-specific model? The driving intent of that was to put us out in front. Put them on notice that we want to be first, so any new considerations or guidance they have, we’d like to be part of that discussion,” Crum said.
Zulkosky asked again: “So you were actively involved in suggesting to the governor to suggest to President Trump that Alaska is interested in Medicaid block grants? Yes or no would suffice.”
“No,” he said.
Dermot Cole is a longtime Alaskan, an author of several history books and a former Daily News-Miner staff columnist. His email address is email@example.com.