State of Alaska
Fiscal Note
Bill Version: HB 59
2023 Legislative Session
Fiscal Note Number: 1
(H) Publish Date: 2/3/2023
Identifier: LL0583-2-DOH-MS-1-27-2023 Department: Department of Health
Title: MEDICAID ELIGIBILITY: POSTPARTUM Appropriation: Medicaid Services
MOTHERS Allocation: Medicaid Services
Sponsor: RLS BY REQUEST OF THE GOVERNOR OMB Component Number: 3234
Requester: Governor
Note: Amounts do not include inflation unless otherwise noted below. (Thousands of Dollars)
Included in
FY2024 Governor's
Appropriation FY2024 Out-Year Cost Estimates
Requested Request
OPERATING EXPENDITURES FY 2024 FY 2024 FY 2025 FY 2026 FY 2027 FY 2028 FY 2029
Personal Services
Capital Outlay
Grants & Benefits 2,600.0 2,600.0 2,600.0 2,600.0 2,600.0 2,600.0
Total Operating 0.0 2,600.0 2,600.0 2,600.0 2,600.0 2,600.0 2,600.0
Fund Source (Operating Only)
1004 Gen Fund (UGF) 2,600.0 2,600.0 2,600.0 2,600.0 2,600.0 2,600.0
Total 0.0 2,600.0 2,600.0 2,600.0 2,600.0 2,600.0 2,600.0
Change in Revenues
Total 0.0 0.0 0.0 0.0 0.0 0.0 0.0
Estimated SUPPLEMENTAL (FY2023) cost: 0.0 (separate supplemental appropriation required)
Estimated CAPITAL (FY2024) cost: 0.0 (separate capital appropriation required)
Does the bill create or modify a new fund or account? No
(Supplemental/Capital/New Fund - discuss reasons and fund source(s) in analysis section)
Does the bill direct, or will the bill result in, regulation changes adopted by your agency? Yes
If yes, by what date are the regulations to be adopted, amended or repealed? 07/01/24
Why this fiscal note differs from previous version/comments:
Initial version.
Prepared By: Terra Serpette Phone: (907)465-6333
Division: Medicaid Services Date: 01/19/2023 05:03 PM
Approved By: Josie Stern, Assistant Commissioner Date: 01/27/23
Agency: Department of Health
Printed 2/3/2023 Page 1 of 2 Control Code: mlKKl
HB 59 - Fiscal Note 1
This legislation intends to authorize the Department of Health to implement section 9812 of the American Rescue Plan Act
(ARPA), which allows but does not require the extension of postpartum coverage from the required 60 days to 12 months
for eligible beneficiaries, authorizing the department to implement an extension of postpartum Medicaid coverage up to
the maximum period authorized under federal law.
Alaska is required by sections 1902(e)(5) and 1902(e)(6) of the Social Security Act to extend Medicaid coverage for 60 days
during the postpartum period if a person applied for and was receiving any category of Alaska Medicaid on or before the
date of termination of the pregnancy. There is no eligibility test for this continued coverage.
This extends postpartum coverage through the year postdelivery. Moving between health plans leads to gaps in care
associated with increased use of the emergency room and poorer health outcomes. With extended postpartum coverage,
women are much more likely to have access to continuous, regular primary care that is less costly than emergent services.
This legislation is anticipated to increase Medicaid expenditures as it extends Medicaid benefits for ten months for a
subsection of individuals eligible for the pregnancy eligibility group but not otherwise eligible for Medicaid under an
alternate eligibility category. However, given the anticipated reduction in services required to respond to emergent and
chronic conditions, it is reasonable to expect the department to, over time, experience cost savings related to extended
postpartum coverage.
Implementation of this legislation does not require changes to the Medicaid Management Information System (MMIS).
Amends the uncodified law to establish the requirement that the commissioner of health notifies the revisor of statutes
within 30 days of federal approval of the state plan amendment. This provision takes effect only if federal approval occurs
before July 1, 2027.
Establishes that the postpartum extension takes effect on the day after the date the commissioner notifies the revisor of
statutes as described above.
Promulgation of associated regulations will take approximately nine to twelve months following State Plan Amendment
approval by the Centers for Medicare and Medicaid Services, with implementation effective after July 1, 2024.
Cost estimates are based on an estimated 1,596 women receiving an additional 10 months of coverage at a cost of
$566.48 per month. The blended match rate is approximately 71.2%. No additional federal authority is needed.
(Revised 08/26/2022 OMB/LFD) Page 2 of 2
LL0583-2-DOH-MS-1-27-2023 Page 2 of 2 Control Code: mlKKl

Statutes affected:
HB0059A, AM HB 59, introduced 02/03/2023: 47.07.020, 47.07.040, U.S.C