Health Commissioner Valerie Davidson and Alaska Governor Bill Walker announce the state’s plan for Medicaid expansion and reform. (Photo by Annie Feidt, APRN – Anchorage)Health Commissioner Valerie Davidson unveiled two new reports Friday at a press conference in Anchorage she hopes will help make the case for Medicaid expansion.Download AudioThey show Alaska can actually save money by expanding the program, even as the federal match drops below 100 percent. But whether Republican state lawmakers skeptical of expansion will agree with the analysis is an open question.The Healthy Alaska Plan: A Catalyst for ReformMemorandum: Projected Population, Enrollment, Service Costs and Demographics of Medicaid Expansion Beginning in FY2016Health Commissioner Valerie Davidson never misses a chance to promote Medicaid expansion. Even when that chance comes in the form of a cell phone ringer that someone in the press conference crowd forgot to silence:“Maybe it’s somebody calling saying they’re ready to sign up! Which would be great. We’ll be ready this summer,” she said.A lot has to happen between now and this summer – July specifically – when Davidson hopes to role out expansion. The health department is devoting extra resources to fix big problems with the systems that enroll new Medicaid members and pay providers for services. The biggest obstacle, though, will be Republican state lawmakers, who have to approve the receipt of federal Medicaid expansion funds in the budget. Many say the state can’t afford to expand the Medicaid program, which is already one of the biggest drivers of the state budget. But Davidson says the new analysis shows Medicaid expansion won’t cost the state, even when the federal match drops to 90 percent in 2020.“We’ve… identified some pretty significant savings and Alaska actually saves general fund dollars by covering this new population,” Davidson said.State prisoners, for example, would be eligible for Medicaid expansion, saving the state $4-7 million a year, according to the report. The health department would also be able to redirect millions of dollars in grant money that is currently used to help the population who would be eligible for expansion. Davidson also wants expansion to spur the process of reducing the cost of the entire Medicaid program. She thinks the cost savings combined with reform will convince lawmakers to approve it:“Quite frankly I think there are some legislators who aren’t necessarily so hot on expansion but they’re interested in reform and if the two go hand in hand and we can show that there are savings to the state at a time when we are looking for those savings opportunities in our general fund, then I believe they’ll come on board,” Davidson said.Republican legislators declined to comment until they had more time to review the reports. Earlier Friday, Senate President Kevin Meyer, of Anchorage, said he was open to Medicaid expansion if it didn’t cost the state any money.In the coming weeks, they will be hearing from a long list of organizations that support expansion, including the Alaska Mental Health Trust Authority. The organization is pledging $1.6 million for the first year of expansion to cover the state’s share of administrative costs. Jeff Jesse is chief executive office with the trust, which serves Alaskans with substance abuse problems, mental illness and cognitive disabilities. He says it makes sense for the trust to help out because expansion will benefit Alaskans the group serves.“The Trustees certainly had to think about the cost issue, but the purpose of the Mental Health Trust is to be a catalyst for change and assist in enhancing our service system for our beneficiaries, so this is a very appropriate project for the trust,” Jesse said.The Trust is also giving $300,000 to the health department to pay national experts to study successful Medicaid cost reform efforts in other states.About 40,000, mostly childless adults, would be eligible for Medicaid expansion. But in the first full year of implementation, according to the new report, only half of those who are eligible would sign up.This story is part of a reporting partnership between APRN, NPR and Kaiser Health News.
Better Call Saul took its time getting back into things even more than it usually does. The story in this series moves at a very slow pace, but that’s OK. We already know where these pieces end up, so the tension comes from watching them fall into place. This might actually be the one show that’s more fun to watch when it moves slower.Season three kicked off with an extended look at the life of Gene, the man Jimmy/Saul becomes after Breaking Bad. We see him working in the Omaha, Nebraska Cinnabon of which he’s the manager. On his lunch break, he spots a kid stealing some DVDs and hiding from the police in a photo booth. He points the kid out to the cops, but for a moment, he remembers who he used to be. He advises the kid to stay silent and get a lawyer. The cops call him an asshole, and he returns to work, spreading white goo over processed cinnamon rolls. Then, he collapses on the floor. These black and white season openers are becoming as interesting as the rest of the show.The main story picks up right where season two left off. Jimmy leaves his brother to call HHM and tell them that Chuck will return to work after all. While he’s out, Chuck hides his tape recorder in his desk for later. Jimmy walks back in and helps his brother take down all the aluminum foil from the walls while Chuck lectures him about finesse. For a moment, it seems like everything is back to normal. They’re brothers again. It doesn’t last long. Jimmy brings up some old memories, and Chuck shoots him down. Chuck promises that Jimmy will pay.Michael McKean and Bob Odenkirk (Photo by Michele K. Short/AMWhen Jimmy returns to his own office, where Kim has been forced to take on some of his clients, he tells Kim that for ten minutes, Chuck didn’t hate him. “I forgot what that was like,” he says. That might be the saddest line of the whole series. Vince Gilligan knows the art of the gut punch. At this point, it’s unclear just how Chuck intends to make Jimmy pay. He plays the tape for Howard, who immediately points out that a secret recording wouldn’t be admitted in court. Even if it was, Jimmy would find a way out. Chuck, of course, knows all this but doesn’t seem bothered. He appears to have a long con in mind. Later, when Ernesto is delivering groceries, Chuck has him replace the batteries in his tape recorder. When he accidentally hears part of the recording, Chuck makes Ernesto promise not to tell anyone. What is he planning?That sense of dread is really what makes the episode’s slow pace work. The entire hour is spent building anticipation. We know something is coming, but it’s not here yet. Kim, feeling guilty over how she ended up with Mesa Verde as a client, dreads making a similar mistake. She spends her entire evening agonizing over a semicolon. Jimmy, on the other hand, meets the Air Force soldier he tricked into letting him use the bomber for his TV commercial. While there are no immediate consequences, the man warns Jimmy that he’ll get his comeuppance eventually. That will definitely come up again later this season.Jonathan Banks (Photo by Michele K. Short/AMC)Finally, Mike had his most tense episode in a while. After receiving the mysterious note warning him against killing Hector Salamanca, he takes the car to a junkyard and rips it apart. Not finding anything, he asks the manager to call him a cab before realizing he hadn’t checked inside the gas cap. Sure enough, there’s a tracker in there. When he gets home, he checks his car and finds another tracker in that gas cap. He orders an identical model from his electronics dealer, swaps it out with the one in his gas cap and breaks the one that isn’t his. He stays up all night watching his car until finally, someone comes to take away his gas cap. Now that he’s able to track the people who have been messing with his cars, he follows them.A very slow first episode expertly set things up for the season to come, and it did it while moving the plot forward, and giving us a tense, entertaining hour of TV. The first two seasons made Jimmy someone we care about, so I’m anxious about what Chuck has planned. We also know that Mike is going to meet Gus Fring this season, but they’re making us wait. As unbearable as that can be, it certainly builds tension nicely. Once again, this methodical character study has me hooked for another season.