This story was originally published by Dermot Cole, Reporting from Alaska.
Sen. Dan Sullivan wants to preserve Medicaid for the “most vulnerable” among us.
This would mean stripping coverage from tens of thousands of Alaskans who are merely vulnerable. Or offering that the state pick up the cost. An offer the state will refuse.
The budget blueprint adopted by House and Senate Republicans proposes that the committee overseeing Medicare and Medicaid come up with $880 billion in budget cuts over a decade.
Medicaid is a chief GOP target and the Republican talking point is that the system should be restructured to reduce the number of people who qualify or to require states to pick up far more of the cost.
Sullivan castigated Democrats for opposing his amendment to protect Medicaid for the “most vulnerable,” claiming they were hypocrites who don’t want to protect Medicaid.
But when an amendment to delete budget instructions to slash Medicaid came up for a vote, Sullivan opposed that attempt to protect Medicaid.
Sen. Lisa Murkowski supported the amendment, which failed 49-50. “I supported an amendment to strike that instruction during our late-night vote, but unfortunately, it fell short,” she said earlier this month.
Sullivan’s unfortunate vote to defend the idea of reductions from Medicaid helped guarantee that the plan to cut $880 billion—which would lead to tens of thousands of Alaskans losing Medicaid coverage if the state does not pick up the cost—remains alive in Congress. In the House, Rep. Nick Begich already backed the budget measure with the $880 billion reduction.
Alaska is one of 40 states that expanded Medicaid coverage under Obamacare. In Alaska, this meant that adults with incomes up to 138 percent above the poverty level got health care.
Nearly 40 percent of Alaskans are on Medicaid.
The federal government pays 90 percent of the cost of coverage for the 76,000 Alaskans who receive coverage under the expansion program.
Sullivan won’t make this clear to Alaskans, but supporting Medicaid only for the “most vulnerable” would be a disaster for health care in Alaska and not just those who would lose insurance. It would damage the hospitals and clinics that have seen a big decrease in unpaid medical debt since Medicaid expansion.
In speaking of the Sullivan amendment, Wyoming Sen. John Barrasso claimed that opposing the Sullivan amendment was the equivalent of supporting the “schemers and the scammers” who take advantage of Medicaid.
Sullivan said something similar.
“We should all want to weed out waste, fraud and abuse in Medicaid and Medicare,” said Sullivan.
But removing coverage from tens of thousands Alaskans is not weeding out waste, fraud and abuse.
When Sullivan rose to speak about his amendment on the Senate floor, he said he wanted to protect Medicaid, but he failed to mention his “most vulnerable” qualifier.
“My amendment says we are going to strengthen Medicaid and Medicare so that they are available for years to come because these are important programs,” he said. “They are certainly important programs to the Alaskans I represent.”
The programs are not just important to the “most vulnerable” Alaskans, however.
Oregon Sen. Ron Wyden correctly diagnosed the Sullivan linguistic sleight-of-hand by saying that this is a ruse to remove insurance from low-income people who are not regarded by Sullivan and other Republicans as worthy of federal support.
“Sen. Sullivan is out there saying that he is for protecting vulnerable people, but by not defining the vulnerable, the Sullivan amendment is code for the states to cut benefits or kick people off their coverage altogether,” said Wyden.
“To me, the Sullivan amendment basically says that if somebody thinks you are not poor enough, you are not sick enough, or you are not disabled enough, we are not going to be there for you,” Wyden said.
Rather than directly addressing the reality that this is about cutting the cost of Medicaid by reducing the number of people on Medicaid, Sullivan dodged and deflected.
He claimed that his proof that he doesn’t want to reduce the number of people on Medicaid is that Democrats, including Wyden, supported an identical amendment in 2017.
“Talk about a ruse. This is the worst kind of partisanship, using people’s healthcare to fear monger,” Sullivan claimed.
But Sullivan does want to cut costs by reducing Medicaid enrollment. That’s the only way to get close to the $880 billion reduction in spending he voted to support. This is not waste, fraud and abuse.
Wyden claims the difference between now and 2017 is that the experience of the pandemic showed how important Medicaid expansion has been. I don’t buy that either. Perhaps Democrats weren’t paying attention.
The October 18, 2017 amendment came from the late Sen. Orrin Hatch, who said Medicaid expenses were growing at an astronomical rate and that Medicaid and Medicare were at the heart of the “entitlement crisis.” Hatch was also careful not to admit that his solution to Medicaid was to reduce the number of people on Medicaid.
Like Hatch, Sullivan opposed the expansion of Medicaid and wanted to repeal Obamacare.
Sullivan ran for Senate in 2014 adopting the mindless “repeal and replace” chant. He talked about “freedom-based” health care, which would have been almost as good as imaginary Trumpcare.
“You’re going to have such great health care at a fraction of the cost,” Sullivan could have said. “And it’s going to be so easy.”
In 2017, Sullivan’s office produced this 14-page “Dear Alaskan” treatise in which he supported plans to shift costs from the federal government to the state to save money. This was part of the Obamacare repeal effort that failed, thanks to Sens. Lisa Murkowski, Susan Collins and John McCain.
Sullivan complained that Obamacare “funds able-bodied Americans above the poverty level at a much more generous federal match” than traditional Medicaid.
He said the expansion coverage was “very generous.” He claimed the responsible thing to do was to reduce the amount the federal government paid to the state from 90 percent to 50 percent by 2024.
Shifting costs to the state would mean an “equal split.” He said that no one would be forced off Medicaid by the changes, as long as the state agreed to pick up a much bigger part of the tab.
This is what it means to protect the “most vulnerable.”
Dermot Cole has worked as a newspaper reporter, columnist and author in Alaska for more than 40 years. Support his work here.
