The Alaska Supreme Court today issued a ruling clearing the way for Alaska to expand Medicaid, and the U.S. Department of Health and Human Services (HHS) officially approved the state’s Medicaid expansion plan.

HHS Secretary Sylvia Burwell sent the state a letter confirming that the state can get expansion program waivers it had requested, Gov. Bill Walker announced today.

Republican state lawmakers have objected, but Walker, an independent who started his race for the governor’s seat by running in a Republican primary, has estimated that expanding Medicaid will bring $146 million to Alaska in the first year and cut state spending by $6.6 million. 

Walker’s administration is hoping to use PPACA Medicaid expansion money to provide coverage for about 20,000 working adults. The state’s Medicaid and Children’s Health Insurance Plan (CHIP) programs now have about 123,000 enrollees.

See also: Tennessee to expand Medicaid as Republicans adapt to PPACA

Alaska had asked for several exceptions to the usual Medicaid rules.

Alaska asked, for example, for permission to use Medicaid money to pay for inpatient care for adults with serious mental health or substance abuse problems, according to a summary of the state’s waiver requests. Alaska needs to be able to pay for inpatient mental health care because it has a small population, a large area and a limited supply of behavioral health care providers, state officials told HHS.

Alaska also asked the Medicaid program to reimburse it for 100 percent of the medically necessary travel costs of Alaskan Natives and American Indians who get care at Indian Health Service facilities.

Burwell approved the waiver requests.

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