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Cassidy-Graham bill provision would exempt Alaska, Montana from a cap on Medicaid spending

As GOP leaders continue to drum up support for the health-care proposal written by Republican Sens. Bill Cassidy (La.) and Lindsey O. Graham (S.C.), a provision buried deep in the 140-page bill benefiting Alaska has begun to draw greater scrutiny.

Beginning on page 95, the bill has a provision that exempts low-density states whose block grants either decrease or stay flat between 2020 and 2026 from the Medicaid per capita cap. Under that scenario, Alaska and Montana would be exempted from the funding cap that applies to all other states during that period.

Sen. Lisa Murkowski (R-Alaska) has been negotiating behind closed doors with Senate GOP leaders on the measure, and neither she nor the state’s junior senator, Dan Sullivan (R), have said how they would vote if the legislation came to the floor next week. Alaska Gov. Bill Walker (I) joined nine other governors Tuesday in sending a letter to Senate leaders indicating opposition to Cassidy-Graham in its current form.

In an interview Thursday, Walker said he was still looking for the kind of assurances that would allow him to support the bill but had not yet received them.

“I’m concerned about protecting Alaskans, and my comfort level is just not there yet,” he said, adding that the bill has to be written “in such a way that Alaska does not get hurt in the process.”

Constraining federal health-care dollars through a fixed block grant, Walker said, poses particular problems because Alaska has so many remote communities and that, in turn, drives up the cost of health-care delivery.

“You can’t drive to 82 percent of our communities. That’s a concern,” he said. “When it comes to our health-care costs, they’re clearly the highest in the nation.”

At the moment, neither Murkowski nor Sullivan are discussing any possible changes to the health care bill. Murkowski’s office did not respond to a request for comment, while Sullivan spokesman Mike Anderson said in an email, “The senator doesn’t comment on rumors.”

“Throughout this process, he has been very focused on doing what’s best for all Alaskans and will comment when the final draft is released and he’s had time to review the language and the data,” Sullivan said.