Advocacy and Public Policy

The Mat-Su Health Foundation theory of change calls on us to increase advocacy, community organizing and civic engagement to promote health equity and produce positive health outcomes for all Mat-Su residents. Data-driven work in the public policy arena is a key part of the systems changes we are striving for.

2023 Advocacy Priorities: Policies to Advance Health, Well-Being, and Equity in 2022

Ensure Equitable Access to High-Quality Healthcare

Alaska’s healthcare costs have been and are one of the highest in the nation. Where possible, like with our borough’s largest employer, the Mat-Su Borough School District, employers cost-shift these growing healthcare costs back to employees, causing additional wage stagnation. The fastest growing charity care population at Mat-Su Regional is the insured with high deductible healthcare plans because more businesses are shifting to these to address the rising costs. The proportion of family income going to healthcare increases almost every year, resulting in families delaying care and treatment until illness becomes acute.  Healthcare bills are the number one cause of bankruptcy in America.

Governments are the largest providers of employer-sponsor health insurance, plus ensure retirees, Medicaid beneficiaries, and special populations like the incarcerated, so they have lots of incentives to engage in health reform efforts and save costs.  While Medicaid is a key part of Alaska’s health insurance landscape, serving more than 260,000 Alaskans and 40,000 Mat-Su residents of all ages, the State appropriates less general fund dollars to Medicaid than it did 10 years ago, despite providing healthcare coverage to more Alaskans than ever before.

Access to healthcare is impacted by many factors, including cost, insurance status, provider availability, and transportation. We support strategies that improve equitable access to healthcare and those that can bring down healthcare costs for individuals, families, and businesses (not just for healthcare providers). Strategies we support include:

  • Increasing primary health care expenditure per capita and access to primary care by vulnerable populations.
  • Applying healthcare cost and quality data to better manage the delivery of healthcare in Alaska.
    • Pass legislation to implement an All-Payer Claims Database (APCD)and compel payors to submit their data so that Alaska can better assess cost and quality of healthcare services.
    • Pass legislation and/or regulation to coordinate the APCD and Health Information Exchange (HIE) as a functioning data utility.
    • Create a Community Care Organization (CCO) Model that is funded and sustained to improve health and well-being of every community.
    • Design a system that incentivizes whole person care and changes how we pay specialists versus behavioral health, etc.
    • Reduce the amount consumers and providers spend on administrative burden.
  • Other health reform efforts that achieve the following:
    • Health coverage with common basic benefits for all.
    • Whole person/integrated systems of care supported by appropriate payment mechanisms.
    • Innovative, emerging, and evidence-informed healthcare delivery practices supporting a diverse community of users.
    • Incorporate upstream social determinants of health in healthcare policy.
    • Holistic infrastructure that supports technology solutions and adaptive practices with timely data and access.
  • Strengthening Medicaid services for all eligible Alaskans.
    • Continued support for meaningful Medicaid reform to provide upstream intervention and prevention. Adequate reimbursement rates for Medicaid and Medicare providers.
    • A Medicaid redetermination plan at the end of the national Public Health Emergency that gives current recipients a fair opportunity to maintain their coverage.
    • Adequate funding and availability of Behavioral Health services.

Improve Social Determinants of Health

Unmet nonmedical needs including healthy food, stable housing and access to transportation have a more significant impact on an individual’s health than the hospital and clinical care they receive. As noted in the 2022 and 2019 Mat-Su Health Foundation Community Health Needs Assessments, health starts where we live, learn work and play. The social fabric and community conditions—for example, affordable housing, quality education, reliable transportation, and a thriving environment—contribute significantly to one’s overall well-being. We support policy and regulation change that achieve the following:

  • All Mat-Su residents have equitable opportunities to meet their basic needs for food, housing, employment, and transportation.
  • Robust investments in early childhood—both Pre-K and childcare—to  ensure that all families, regardless of income, have access to safe, reliable childcare so that they can participate in the workforce.
  • Adequate funding for Special Supplemental Nutrition Program (SNAP) and implementing previously passed legislation to make all public assistance applications available online.
  • Adequate funding for programs that serve our most vulnerable residents including older Alaskans, the fastest-growing segment of Mat-Su’s population.
  • Exploration of an 1115 waiver to allow Medicaid funds to address social determinants of health.

Support Workforce Development

Building the healthcare workforce of tomorrow requires action today. Over the next ten years the healthcare industry is expected to add more jobs than any other industry, but we do not have adequate training capacity to put Alaskans in those jobs. Strategies we support include:

  • Passage of legislation to allow Alaska to join the 39 states and jurisdictions that are part of the multistate nurse licensure compact
  • Ongoing support for the WWAMI program, a partnership with the University of Washington Medical School that is the single largest contributor of physicians to Alaska’s workforce.
  • Ongoing support for the SHARP program which provides incentive for clinicians to work in Alaska by offering student loan repayment for designated providers in high-need healthcare settings. As a public/ private partnership, this program requires no monetary investment at the State level.
  • Investments in data systems to monitor and forecast health workforce needs.