Mitt Romney was declared the winner in Alaska's Republican district conventions, ensuring he'll have the support of a majority of the state's 24 delegates to the GOP's National Convention.
In a fractious state known for its independent streak – and as the home to Sarah Palin – Romney's selection is intriguing. Alaska is the only state in the nation to decline a $1 million federal grant to help establish a mandated health insurance exchange and has long been one of the mandate's staunchest critics. Yet state officials have also been quietly studying how to establish an exchange.
[Related: Wyoming wants state-based health reform.]
The former Massachusetts governor, who crafted his own health insurance exchange when he was governor of the Commonwealth, didn't visit Alaska during his campaign for the GOP nomination, but did send one of his sons on his behalf. He was endorsed by Republican Sen. Lisa Murkowski and Lieutenant Gov. Mead Treadwell, and penned an open letter to the state's residents vowing that, if elected president, he would champion permit reforms that would allow the state more of a say in tapping its natural resources.
Oil and gas usually take center stage in Alaska politics, as the state has large supplies of both resources.
The state has a little less than 500,000 registered voters, with roughly 131,000 registered as Republican. Four years ago the district conventions yielded only 13,703 votes.
Romney garnered 4,285 votes, or little over 32 percent of the state's Republican votes. Rick Santorum received 29 percent of the vote, Ron Paul (the only candidate to visit the state) received 24 percent and Newt Gingrich polled at 14 percent. The candidates will divvy up Alaska's 24 delegates to the GOP convention.
Alaska, behind Republican Gov. Sean Parnell, is one of the more adamant opponents to President Barack Obama's healthcare insurance exchange mandate – it's the only state to not even apply for a $1 million federal grant to help develop state exchanges. Still, in January, state officials are spending about $200,000 to hire the Boston-based Public Consulting Group to study the state's options.
[Political Malpractice: Former NFL pro, running for Idaho congress, helps voters understand ACA.]
Conversely, federal officials see Alaska as a top candidate to prove the success of health information exchange. The nation's least densely populated state – and one of the most rugged – has a strong provider-payer network in place, supported by the non-profit, multi-stakeholder Alaska eHealth Network, and enjoys across-the-board support for telemedicine initiatives. Analysts say that because the state's telemedicine and HIE efforts are working so well, many Alaskans feel they can have the same success with an insurance exchange.
While most Alaskans have some form of health insurance coverage – significant percentages of the state's population are either government-employed or members of Native American tribal organizations – almost 20 percent lack health insurance, according to a 2010 Kaiser poll.
In a February interview with Kaiser Health News, Josh Applebee, Alaska's deputy director for healthcare policy, said the state is taking a wait-and-see approach on health insurance exchanges, watching other states as they wrestle with the concept. States have until Jan. 1, 2013 to submit their plans for an exchange to federal officials for approval.
"Certainly we deliver healthcare [over greater distances] than any other state and in different ways than any other state," Applebee told KHN. "So they can bring their experience with them, but they also need to apply that to whatever happens here in the state."
Not everyone is in agreement with the state's approach. Sen. Hollis French, a democrat from Anchorage, has submitted a bill to the state legislature to establish an exchange – arguing that it's better that Alaskans create their own exchange than having one be forced upon them by Washington.
"This is really about just trying to find an affordable insurance policy for the citizens of the state, and most people can agree that's a good thing," French told KHN. "They may disagree about how you get there, but it's a pretty rare person who doesn't want to see more people covered by insurance."
For more of our primaries coverage, visit Political Malpractice: Healthcare in the 2012 Election.