07/25/2012 05:32 pm ET Updated Sep 24, 2012

Is Alaska Punting on Health Care?

It's no surprise that Gov. Sean Parnell has been dead set against federal health-care reform, or the Affordable Care Act, or "Obamacare." Alaska, under the Parnell administration, was among 26 states that sued to overturn the health care law, and Parnell has since called for its repeal.

What is surprising is Parnell's June 17 announcement, citing cost, that his administration planned to hand over significant state control of Alaska's health care market to bureaucrats in Washington, D.C., rather than apply for federal grants to fund a health insurance exchange. The state exchanges are fundamental to the national health reform law and were among the most significant concessions by Congress of federal health-care policymaking to the individual states.

Parnell's resistance to federal meddling in Alaska business makes the decision all the more contradictory, some say.

In March 2011, Parnell wrote a letter to Alaska Sen. Hollis French outlining his administration's benchmarks involving the exchange. "Principles that will guide us," he wrote, "will be to maximize Alaskans' freedom and privacy, minimize federal entanglement and foster more citizen-based choices."

The letter was an explanation of sorts for Parnell's decision not to accept $1 million in grants -- money accepted by every other U.S. governor, including those challenging the health law's constitutionality -- offered by the Feds to offset state costs to study and design the exchanges.

"What's going to happen now is that we will get stuck with an exchange that is developed by the federal government," said Pat Luby director of the AARP Alaska. "If the federal government does it, how are we going to make sure that it's working for Alaskans?" he said.

States get a say in health reform

Exchanges are intended to be one stop shops managed by the states or a state-selected nonprofit to provide a single point for comparison shopping of health insurance plans. Alaska's very high rate of uninsured citizens and comparatively few health insurance providers make this a big deal. As many as 77,000 Alaskans will enter the health insurance market once the law has been fully implemented. A carefully designed insurance exchange could conceivably attract more insurers to Alaska. More health insurance options would mean more competition for the business of state health-care providers. And that typically means lower costs and better coverage. ...

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