The state health department says it enrolled more than 1,000 Alaskans in health care coverage in the first two weeks of the newly expanded Medicaid program.
The federal government will pay the full cost of coverage for the newly enrolled individuals this year and next year under provisions of President Barack Obama's health care law. The state will ultimately have to pay 10 percent of the costs of the expanded program by 2020.
About 450 people filed their own applications with the state since expanded enrollment began Sept. 1, according to the Alaska Department of Health and Social Services. The state transferred another 560 people from other assistance programs, said Sarana Schell, a department spokeswoman.
Just under two-thirds of those enrolled were between 42 and 64 years old, and the rest were between 19 and 41 years old, the state said.
State officials are projecting that 20,000 low-income Alaskans will sign up for expanded Medicaid in its first year, adding to about 125,000 people already on the program's rolls. But the health department didn't aggressively advertise the expanded program when it was launched earlier this month; instead officials are planning a more visible campaign when enrollment for 2016 coverage on the federal Healthcare.gov website opens in November.
Alaskans will be able to use that site to enroll in Medicaid coverage or subsidized individual health care plans.
Expanded Medicaid enrollment began earlier this month following eight months of wrangling between the state Legislature and Gov. Bill Walker, who was elected in November.
States were originally required to expand Medicaid under the provisions of Obama's Affordable Care Act. The law offered subsidized health care to people with incomes above the poverty level, but presumed that people making less than 138 percent of the poverty level, about $20,000 for a single adult in Alaska, would be eligible for expanded Medicaid.
Instead, the U.S. Supreme Court said it was unconstitutional to require all states to expand Medicaid and made that move optional. That left about 4 million low-income people around the country, and an estimated 10,500 in Alaska, in a gap where they were both ineligible for existing Medicaid programs and didn't qualify for federal subsidies for individual health care plans, according to data compiled by the Kaiser Family Foundation.
Last year, 17.2 percent of Alaskans were uninsured -- a rate that trailed only Texas, according to data released Wednesday by the U.S. Census Bureau. (That figure, however, includes Alaska Natives who have no other type of health care beyond that provided by the Indian Health Service, which is not considered comprehensive.)
Walker, a Republican-turned-independent who was endorsed by the Democratic Party, promised during his campaign that he would expand Medicaid. But the Republican-led House and Senate blocked his efforts to do so during the Alaska legislative session this year, citing concerns about costs once federal payments for the expanded program drop below 100 percent.
Walker ultimately used his executive power to expand the program beginning Sept. 1, though he first had to win two court rulings once the Legislature sued to stop him. The Legislature's underlying legal challenge is still pending in state court.
Asked about the 1,000 enrollments in the first two weeks, Sen. Mike Dunleavy, R-Wasilla, said it was too soon to draw any conclusions.
"It's too early to tell," said Dunleavy, one of the Legislature's chief Medicaid expansion skeptics. "Some of these things take a while for people to know what's going on."
Schell said in an email that her department had been receiving Medicaid applications "steadily" for the last two weeks. The department's figures show as many as 74 people being enrolled on a single day, Sept. 7, and as few as two on Sept. 11.
Schell said that small number was not due to glitches with the state's enrollment system. Instead, she said, it reflects "the normal up and down of application levels."
The groups that are working under a federal grant to assist Alaskans with insurance sign-ups, meanwhile, are preparing for an uptick in interest when enrollment opens on the federal health care site in November, said the Alaska Primary Care Association's Jessie Menkens, who helps coordinate that work.
For now, the "assisters" trained by her organization have been relishing their new opportunity to direct Alaskans to the expanded Medicaid program. Before Sept. 1, some of the people seeking insurance had to be told that they didn't qualify either for Medicaid or for subsidized individual plans.
"There were countless times when we just had to look someone in the eye and say: 'I'm really sorry, I really don't have an option to present to you, given your circumstances,'" Menkens said. "We'd look at an income guide and explain as carefully as we could: Unfortunately, if they didn't earn this amount, they didn't have the purchasing power necessary to qualify."
She added: "This is like a brand-new world for these people."