Alaska's legislature didn't move to expand Medicaid, so Gov. Bill Walker is doing it on his own. Walker says he plans to accept $146 million in federal funds that his state has access to under the Affordable Care Act in order to cover some 42,000 residents who qualify under the program, Reuters and the New York Times report. Walker, who is just seven months into his term, had made expanding Medicaid a campaign priority. "This is the final option for me," he says. The Legislative Budget and Audit Committee will now have 45 days to act before Walker accepts the funds; he says he can proceed regardless of how the committee responds. The federal government will take on the full cost of the expansion at first, then shave its cut to 90% by 2020.
Some 28 other states have expanded Medicaid under the law, but just Kentucky, West Virginia, and Ohio did so without legislative consent. Walker, who calls the move a "common-sense decision," says his bills seeking expansion approval were all blocked by Republicans worried about the tab Alaska would have to pick up in the future. "Regardless of federal funding, we cannot afford the Medicaid system we have now," says Republican state Sen. Pete Kelly. "Our current system is broken." Walker hopes to begin enrollment in September and have 20,000 signed up within one year. The Wall Street Journal observes that the move will "bring the number of states opting into the law's expansion close to 30 and make it more likely other states would follow."