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No exit: Obamacare forces Alaska to pay for teeth cleaning for Medicaid adults

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The Alaska Department of Health and Social Services will reinstate Alaska’s Medicaid adult preventive dental program (the Adult Enhanced Dental Program), retroactive to Oct. 1, 2019, when it was discontinued due to the State’s budget problems. 

DHSS Commissioner Adam Crum’s decision was based on a lengthy discussion between his department and the Centers for Medicare and Medicaid Services (CMS). The reversal of the State’s position comes because Obamacare is requiring Alaska to reinstate the program.

247,000 unduplicated enrollees were in Medicaid in the last fiscal year, one third of the state population. Over 37,000 Alaska are adults in the expanded Medicaid program that came with Obamacare, covering those with higher incomes — over 200 percent of the poverty level. Children are part of a different program.

Funding for the preventive dental program for adults – $8.3 million of state general funds with a federal match of $18.7 million – is part of Gov. Mike Dunleavy’s FY2021 budget that was released Wednesday. 

Adult enhanced dental services include preventive and restorative dental care such as cleanings, fillings and restorative work.  Those services were originally scheduled to be discontinued July 1, 2019, but were extended through Sept. 30, 2019, to allow time for recipients to receive notice about the Medicaid change and plan their care.

After the program ended on Oct. 1, dental services continued to be available to Medicaid recipients in Alaska through Medicaid’s “emergency dental” program.

The federal agency advised the State of Alaska that while the program is optional for states, most of the dental services included in the program were obligated to continue under federal law, according to the essential benefits plan of the Affordable Care Act’s Medicaid expansion.

Under federal law, preventive dental care services must be covered by Medicaid when provided at federally qualified health centers that offer preventive dental care.

“After many months of discussions and a full review of all of the options, DHSS determined  the best way to meet our obligation to Medicaid recipients and to maintain the fiscal integrity of the program was to reinstate the Adult Enhanced Dental Program,” said Commissioner Crum. “Initially we thought eliminating the program would be best but, because of the program’s complex rules and federal requirements, this was the more prudent option to benefit the health and well-being of Alaskans and our state’s fiscal sustainability.” 

Southcentral President and Chief Executive Officer Katherine Gottlieb said, “This reinstatement of adult dental services to the budget ensures the importance of preventative care in maintaining health, avoiding unnecessary pain and saving many dollars in the long term.” 

DHSS will review all denied claims and prior authorizations from Oct. 1 until now and will provide benefits to recipients according to the original Adult Enhanced Dental Program. The same annual limit of $1,150 for services that was part of the original program will continue to apply. 

Health care providers will receive notice of this change through a remittance advice message from Medicaid next week, the department said. Medicaid recipients will receive letters next week notifying them the dental program will be restored. 

Repeat offender sought in Black Angus Inn slaying

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Brant Marshall, age 39, is now the suspect in the investigation into the Dec. 3 homicide at Black Angus Inn in Anchorage. He previously was a person-of-interest, but became a suspect after police rounded up another person; Brittney D. Johnson, age 40, was questioned Wednesday.
 
An arrest warrant has since been issued for Marshall on charges of Murder 2 and Manslaughter.

Marshall has a long string of offenses going back a decade or more in the Alaska Court system, including sexual abuse of a minor.

Two years ago, he was arrested after police responded to shots fired in the 200 block of 12th Avenue. Marshall was among three men who had forced their way into an apartment by saying they were there to rescue a dog that had been reported stolen. The three posed as police officers during that crime caper.

For that incident, Marshall was charged with Assault III, Robbery I, Burglary I, and Failure to Register as a Sex Offender.

Now, he’s wanted for murder after Grant Fowler, 34, was shot at the inn around 3:15 p.m. on Dec. 3. Fowler was declared dead shortly after arriving at the hospital. It was the fifth shooting at or near the establishment since January, 2018.


House Majority response to budget: We don’t like it

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Members of Alaska House Democrat-led Majority  released statements on the governor’s budget plan just hours after he had revealed his Fiscal Year 2021 spending plan on Wednesday, four days before the statutory deadline.

They didn’t thank him for bringing the plan to them early so they can get to work as appropriators. They didn’t applaud him for taking a different approach this year, after they crossed swords with him last year. Nor did they congratulate him on offering the Operating, Capital, Mental Health, and Supplemental budgets all at once, so they can see the gestalt of what they’re dealing with.

No, they didn’t have much nice to say about it, but at least the House Speaker was happy enough that the budget wasn’t as small as he expected it to be.

House Speaker Bryce Edgmon

“We agree with the governor’s decision to not further cut the budget. However, spending is only half of the budget, and the governor is deferring to the legislature on how to pay for it. Alaska cannot afford to delay tough decisions another year,” House Speaker Bryce Edgmon said.

Edgmon didn’t say what those tough decisions are, but he acknowledged the governor has given them a tough task in a year when the entire House is up for election. Presumably, Edgmon will favor taxes on income, oil, and Permanent Fund dividends.

Rep. Jennifer Johnston, co-chair Finance

“The governor’s proposal would drain the Constitutional Budget Reserve, leaving us unable to withstand any unforeseen financial emergencies. In the last year alone, we saw a record fire season and the largest earthquake since 1964. It would be reckless to drain our primary savings account for the largest PFD in history,” said Rep. Jennifer Johnston of Anchorage, who co-chairs House Finance. A Republican, she has joined the Democrat-led caucus. From her statement, it’s apparent she’ll propose a smaller draw from the Constitutional Budget Reserve, and half a Permanent Fund dividend for qualifying Alaskans.

Rep. Neal Foster, co-chair Finance

“The governor’s budget takes a short-term view. He is detailed about what he wants to spend but is shortsighted in his plan to pay for it. The legislature will hit the ground running in January, and we will work diligently with the administration to complete our work within 90 days,” said Rep. Neal Foster, a Nome Democrat.

Why did Foster say they would complete their work in 90 days? That’s a curious remark that has little to do with the budget or its funding. Last year, the legislative leaders predicted that 90 days was not achievable.

After all, the Legislature has not completed its work in the statutory timeframe since 2014, and the 2019 legislative session didn’t even attempt to meet the deadline.

Foster has tipped the hand of the Democrats, who want to complete their work in 90 days so that they can help the Recall Dunleavy group get onto a special election ballot. If they do gavel out in 90 days, and that’s a big “if,” the recall group will benefit greatly. They have a better chance of taking out the governor via a special election, which is only possible if the Legislature gets out of Juneau on time.

Clarification: The length of the legislative session can benefit the recall committee, depending on how they want to play it. When the recall committee turns in their signatures determines whether it gets attached to the General, Primary or a special election.

This is about politics, left vs. right. If the session goes longer than 90 days, the recall petitioners have more time collect signatures.

Unlike an initiative, which has regimented dates associated with it, if the Legislature adjourns on Day 90, the timeframe becomes whenever the court is done with their decision, whenever the group gets the 78,000 signatures, and whenever they plan strategically to turn in those signatures, because that begins the 30-day signature verification, and the lieutenant governor’ decision to set the election between 60-90 days after that. That window could bump the recall onto the Primary ballot. Or if they delay turning in their signatures, the question could go to the General Election ballot, something the group seeks to avoid. Statute directs the lieutenant governor to put it on the next ballot, if it falls in that timeframe.

Democrats, who control much of what goes on in the Legislature these days, will make a mad dash to get their work done within those 90 days.

Republicans, whose votes are needed to fund the budget with the Constitutional Budget Reserve, are likely to drag their feet in an attempt to rob the Recall Dunleavy camp of that victory.

There’s another reason why Democrats will try to get the budget finished in 90 days: Every one of the 40 House seats are up for election. The incumbents who are running again will not be able to raise money or effectively campaign if they are stuck in special session after special session, as they were in 2019.

In 2019, the Legislature met for 177 days, from January 15 through May 14, 2019, May 16 through June 13 and July 8 through Aug. 6. The incumbents cannot afford to have another year like 2019 if they want to fend of challengers.

The Alaska Senate didn’t issue a statement about the budget, nor did the Republican House Minority.

Alaska Democrats echoed the sentiments of the House Majority, not criticizing the size of the budget but the funding source:

“Smashing the piggy bank rather than repeal oil tax credits. His priority is clear, and it’s not the people of Alaska,” the Democrats offered, pointing to the source of money they want to use for state service.

Trump pick for 9th Circuit confirmed by Senate

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Although the Democrats savaged him and the American Bar Association called him “arrogant, lazy, an ideologue, and lacking in knowledge of the day-to-day practice including procedural rules,” Lawrence VanDyke was confirmed on Wednesday to the Ninth Circuit Court of Appeals, the most liberal appeals court in the nation.

Sen. Ted Cruz of Texas said the ABA “not qualified” rating for VanDyke, who has a Harvard law degree, amounted to finding the man guilty of “practicing law while conservative.” Others said the hit job on VanDyke was a drive-by shooting from the liberal elite.

VanDyke had suffered through a bitterly partisan confirmation process since his nomination was made by President Donald Trump in September.

The only Senate Republican voting against VanDyke was Sen. Susan Collins of Maine.

His confirmation means Trump has appointed nine members to the Ninth Circuit, nearly one third of the judges. Earlier this week, the Senate confirmed an openly gay prosecutor who Trump had nominated to the same court. Patrick Bumatay, who is also of Filipino origins, had a much easier confirmation process.

The Republican-led Senate is confirming plenty of judges these days, including eight last week. VanDyke brings the confirmations to 171 Trump appointments to district and circuit courts. Trump set a goal of having 183 federal judges in place by the end of 2019.

Sarah Pitlyk, who was also confirmed just last week, also received the “Not Qualified” rating from the American Bar Association.

Sen. Mike Lee of Utah has been critical of the American Bar Association’s partisan vetting process, and has asked the White House and Senate Judiciary Committee to remove the ABA from further involvement in the nomination process.

VanDyke, the former solicitor general of Montana, now has a lifetime appointment to the 29-judge panel that is the largest appeals court in the nation, covering issues that matter in the entire west, including Alaska. It is based in San Francisco and has been dominated by liberal judges for years, prompting many to call for a new court to be established for the Northwest.

Journalist who signed recall petition will work at CNN

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Blake Essig, a journalist at KTUU in Anchorage, is one of the newest hires at CNN, where he will be the Tokyo correspondent for CNN International.

Essig joined KTUU in 2012. In 2019, he signed the petition to recall Gov. Mike Dunleavy.

He was still working for KTUU in November when Must Read Alaska reported that he was among several journalists and media managers in Alaska who signed the recall petition during the summer months. However, he is no longer listed on the news company’s website.

‘Intent’ is good enough for judge in Homer city council election-residency case

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An Anchorage judge has decided that a person’s intent to move into a political district is good enough for them to run for office.

According to Judge Josie Garton of Alaska Superior Court, the intent to live somewhere puts the seal of legitimacy on that aspect of a person’s candidacy.

Judge Garton has explained her reasoning for her Dec. 9 decision not granting a temporary restraining order against Homer City Councilwoman Storm Hansen-Cavasos.

[Read: Round One: Homer litigants denied in court]

Tom Stroozas, the Homer resident bringing the complaint against the Homer City Council for seating Hansen-Cavasos, is unlikely to pursue the case; without the temporary restraining order, the court matter could last for two years.

The judge’s ruling means that the case won’t be fast-tracked by the court system and that Hansen-Cavasos will be able to serve for most of her elected term before the case actually would ever be resolved. By then, they’ll be into another election cycle in Homer.

Dropping the case, however, allows the ruling to stand as case law, and has impacts in other jurisdictions.

BACKGROUND IN A NUTSHELL

Storm Hansen-Cavasos lived outside of Homer city limits, and intended to move into the city during the year prior to the Oct. 1 municipal election. There was a lot of evidence that she had not moved before October, 2018. She had, however, moved by August, 2019, filed for city council in August, and was elected to the post in October.

According to the judge’s explanation, while verifying the qualifications of candidates running for Homer City Council, a deputy clerk noted that Hansen-Cavasos was not on the October, 2018 voter rolls. She notified the city clerk, who had a conversation with Hansen-Cavasos, and researched the matter with the Alaska Division of Elections, before deciding that Hansen-Cavasos met the criteria for living in the city limits for the year leading up to the election.

Judge Garton used the word “intent” several time in her legal explanation, released Dec. 10. She noted that the likelihood of the plaintiffs winning the case was improbable. Must Read Alaska’s efforts to reach Stroozas for comment were unsuccessful.

Dept. of Law has reviewed ‘Pirate’ case dismissal, and says it was appropriate

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The reappearance in Fairbanks of a man who calls himself Pirate has led to both citizen outrage and media focus in recent weeks. Pirate had been indicted by a grand jury in 2015 for many counts of sexual assault, kidnapping, and assault that occurred after he took a woman to his cabin in Manley Hot Springs and allegedly brutalized her.

[Read: Pirate back in Fairbanks, some are concerned]

Formerly known as Daniel Lloyd Selovich, the now-mostly homeless man with tattoos on his face was released when in 2016 the victim died and the Fairbanks District Attorney dismissed the charges. 

In response to citizens’ concerns, the Fairbanks District Attorney and Deputy District Attorney conducted a review of the 2015 case against the defendant and the circumstances of its dismissal. 

“The Department of Law has completed its review of the evidence and concluded the dismissal of the 2015 case, while extremely frustrating, was appropriate under the law,” according to a statement from the Department of Law on Thursday. The case dismissal came because without a victim to testify, Pirate would not be given a fair trial in which he could face his accuser and where she could be cross-examined by his attorney.

A group on Facebook formed to keep an eye on Pirate and report sightings of him, and the news media has reported about how others with extensive and similar facial tattoos are being confused with Pirate and have been harassed.

Principal in Bethel busted by FBI Child Exploitation unit

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Gladys Jung Elementary School Principal Christopher Carmichael has been arrested by the FBI, Bethel Police Department and Alaska State Troopers.

The FBI’s ‘s Child Exploitation Task Force on Tuesday confiscated various forms of digital media from the school, where Carmichael has worked as principal since 2014. He has been with the Lower Kuskokwim School District since 2000.

The arrest came on Tuesday, with charges expected by Thursday, and he was booked into the Yukon Kuskokwim Correctional Center after midnight on Dec. 11. No charges are posted, as of Wednesday evening.

By Wednesday afternoon, Carmichael had been removed from both the school district and the school’s website, and a press release had been issued:

For a thriving economy, government spend must come down even more

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By DONNA KAURANEN

One year ago, Gov. Mike Dunleavy submitted a budget representing the starting place for his budget challenge, a gap of $1.5 billion dollars on a $6.7 billion state funds budget, over a 20% difference between annual revenues and expenditures.

While Alaska’s budget gap had developed over time, the governor directed his Office of Management and Budget team to provide him options to close that gap in one year with no new revenues and no borrowing from reserves.

Alaska had borrowed from reserves for six years, drawing down rainy day funds and racking up a debt of over $10 billion to the Constitutional Budget Reserve (CBR). OMB worked with state agencies and brought options to the governor to meet his direction.

The Permanent Fund Dividend is not included in these numbers because, while the Alaska courts have ruled the Legislature can ignore statute and set a dividend amount through the budget, the governor has been, rightly, steadfast in his policy that dividends must be distributed according to decades-old law to Alaskans who are the owners of subsurface resources.

After the governor’s final budget submission in February, he made presentations around the state, some with Commissioner of Revenue Bruce Tangeman and me, laying out the case in numbers and graphs that Alaska had been spending beyond its means for years and needed to cut its budget, and that it was running out of time to do so, given the squandering of reserves that preceded his governorship.

He has more than one year to fulfill his policies, but seems to be taking budget reducing options off the table and is instead tilting toward additional taxes.

In addition to the mathematical reality, there was an economic reality to the governor’s policies. My former colleague and Alaska economist Ed King has been telling us consistently, Alaska is a high-taxed state. While this economic fact may not be obvious, as Milton Friedman said:

“Keep your eye on one thing and one thing only: how much government is spending, because that’s the true tax … If you’re not paying for it in the form of explicit taxes, you’re paying for it indirectly in the form of inflation or in the form of borrowing. The thing you should keep your eye on is what government spends, and the real problem is to hold down government spending as a fraction of our income, and if you do that, you can stop worrying about the debt.”

Every dollar government spends is a dollar not used for labor or investment in the private economy. If Alaska desires a diversified economy with a thriving private sector, it must reduce the amount of money government spends.

Alaska’s state government spends more than twice the amount on government than the national average of states on a per capita basis, or $13,000 per every man, woman and child in Alaska compared to $6,000 in other states.

While Alaska enjoys a strong GDP per capita, a significant portion of its GDP goes to government. In addition, Alaska’s private economy is significantly dependent upon government.

Compare Alaska to Florida, for example, a state whose existence was largely developed after the U.S. Army Corps of Engineers dredged the Everglades and when the availability of electrical air conditioning occurred not long before Alaska’s Statehood.

Florida’s state government spending per capita ($3,640) is only 27.6 percent of Alaska’s government spending per capita of $13,000.

State spending compared to state GDP in Alaska is over 18 percent while Florida’s is 7.5 percent.

Alaska’s government debt compared to state GDP is almost 20 percent, while Florida’s is just over 12 percent.

Alaska consistently loses population to other states, while Florida has had the second highest net domestic migration over the last decade.

The Fraser Institute measures the economic freedom of states based on taxes, spending, and labor market freedom. The Frazier Institute ranks Florida second best and Alaska third worst state on its economic freedom index.

I have learned through my vast experience that sticking with fiscal and economic policies that are politically difficult in the short run are economically beneficial for the long term. Washington D.C. has shown us this recently as the U.S. economy is enjoying the benefits of the Tax Cut and Jobs Act of 2017, including a 50-year low in the nation’s jobless rate.

Alaska is a beautiful state with tremendous opportunities if its leaders are willing to do what’s necessary to embrace them.

Donna Arduin Kauranen  is the former director of the Office of Management and Budget and is the president of Arduin, Laffer & Moore Econometrics .