Tuesday marked the first day for thousands of newly eligible Alaskans to enroll in Medicaid after Gov. Bill Walker expanded the program, but it was a quiet afternoon at a state office in Anchorage that handles applications.
Two people waited in chairs. Another stood. And those three weren't waiting at the state Division of Public Assistance to enroll.
When asked if anyone had come in to sign up for the newly broadened health care program, a woman who sat behind the front desk said, "I haven't had anyone yet today."
By some estimates, expanding Medicaid could provide health care coverage for about 40,000 Alaskans. The state Department of Health and Social Services has said it expects 21,000 Alaskans to sign up in the first year.
Exactly how many of those Alaskans chose to submit their Medicaid applications on the first day of expansion was unknown by late Tuesday -- the state health department said it would not release official numbers until Wednesday.
Sarana Schell, a public information officer for the state health department, said Alaskans can sign up for Medicaid online or in person at Division of Public Assistance offices around the state. By Tuesday afternoon, very few people had lined up in any of the offices to do that, she said.
"DPA (has had) very little increase in foot traffic this morning," she said in an email Tuesday afternoon. "A few offices experienced higher than normal call volume which typically happens at the beginning of the month anyway since it's peak time for applications and inquires."
As Medicaid expansion moves forward in Alaska, a lawsuit on the issue continues to simmer between Gov. Bill Walker's administration and the state Legislature.
Walker, a Republican-turned-independent, made expanding Medicaid one of the cornerstones of his 2014 campaign for governor. After the Republican-led Legislature rejected expansion during its latest session, Walker announced in July that he would use his executive power to accept federal money and expand Medicaid anyway.
The Legislative Council, acting on behalf of the Legislature, sued Walker's administration in August. The council asked a state Superior Court judge, and then the Supreme Court, to intervene and temporarily block enrollment until the case could be argued, but the courts refused. Medicaid expansion took effect Tuesday.
With President Barack Obama in town, White House Press Secretary Josh Earnest praised Walker's decision to expand Medicaid in a prepared statement Tuesday. He said Alaska has become the 29th state, in addition to Washington, D.C., to "implement this option and prioritize the health of the state's citizens over narrow political interests."
"Hospitals and businesses throughout Alaska will save on uncompensated care costs, and hardworking families will gain the peace of mind that comes with health security," said Earnest, who is traveling Alaska this week with the president.
Medicaid expansion was a key part of Obama's Affordable Care Act, signed into law in 2010. In a 2012 decision, the Supreme Court struck down mandatory expansion, leaving the decision up to the states.
At the Anchorage Neighborhood Health Center on Tuesday, Samantha Longacre, who has been helping people sign up for coverage under the Affordable Care Act, said she walked four people through applying for Medicaid on Tuesday and booked appointments for six others.
Jon Zasada, Anchorage Neighborhood Health Center's director of development and marketing, said Monday that the health center determined that 5,865 of its patients last year may have benefited from expanded Medicaid. He said the health center would contact those patients and suggest they learn more about enrollment. But, he said, the health center did not plan to do any "mass education" on Medicaid expansion for another month or so.
"We are 100 percent supporting the state of Alaska in keeping this as soft a launch as possible," Zasada said Monday. "We're not calling great deals of attention to it. We're certainly, in-house, going to be flagging uninsured patients who we believe would be eligible, but we are not doing more than that."
Longacre said that the Medicaid applications took 30 to 45 minutes to complete. She helped people enroll for Medicaid through healthcare.gov, the federal health insurance exchange.
"They're pretty straightforward," Longacre said of the applications, comparing them to those for health care plans. "This whole expansion group is largely single adults with little incomes, so there aren't as many names to put in there and birthdays and there not as many incomes to divvy out. It's a little more streamlined."
Before Medicaid expansion, low-income Alaskans covered by the health care program included parents, children, pregnant women and people in foster care up to age 26 -- leaving out adults without children.
Expansion has opened up access for adults between ages 19 and 64 who earn less than 138 percent of the federal poverty level (or an annual income of about $20,000 for a single adult).
Alaskans can apply for Medicaid under the expansion online through healthcare.gov or the state's Division of Public Assistance's self-service website, said Jenny Belanger, training manager for the state's Division of Public Assistance. They can also download an application and mail it to a Public Assistance office or fill out the paperwork there, she said.
There is no open enrollment period for Medicaid, like for private health insurance, Schell said. Alaskans can enroll in Medicaid at any time and benefits can apply retroactively, though not further back than Sept. 1, said health department spokeswoman Schell.