Spending: Medicaid
Medicaid provides health coverage and long-term care services for low-income Alaskans. It is jointly (federal and state) funded and administered by the state within federal guidelines. The State’s cost for the Medicaid program is $694 million plus an additional $1.8 billion in Federal funds.
As of last January, 262,114 Alaskans were enrolled in the program. Post-COVID, some no longer are eligible for coverage, which will reduce some costs going forward; however, the rate that the State must match Federal funds is increasing from 50% to 56.2%. At the same time and due to a lack of funding, more than 400 Alaskans with disabilities are on a waitlist to receive Home and Community Based Services.
In recent years Medicaid reform legislation has resulted in over $150 million in state cost savings annually through program efficiencies, federal tribal reimbursement, drug price negotiations, and targeted case management.
While the Federal government mandates certain services be covered under Medicaid including nursing home care when needed, it also has other services considered "optional," which range from dental services, at-home personal care services, to prescription drugs. These can be less expensive than what would otherwise be a mandatory alternative such as home care versus nursing home care or preventive dental care versus emergency. Over 90,000 Alaskans have been able to access optional services.