Medicaid cuts leave Alaskans facing loss of health insurance, hospitals facing closure

Sweeping budget cuts to Medicaid contained in the budget bill President Donald Trump signed into law last year are endangering Alaskan hospitals, potentially leaving thousands of people without health insurance, and fracturing an already fragile medical landscape in a state where the majority of communities are not accessible by road, nurses and healthcare advocates say. 

“Medicaid is not an abstract program; it’s a foundational part of Alaska’s healthcare system,” Amber Lee, the director of Protect Our Care Alaska, said during an April 17 forum.

“When that funding is cut, the consequences are immediate and severe,” continued Lee, whose organization advocates for affordable healthcare in Alaska. “Emergency departments and maternity wards close, care becomes harder to access, and entire regions are left without reliable health services. These decisions don’t happen in a vacuum. Every service reduction in every hospital pushed to the brink reflects a policy choice, one that prioritizes tax breaks for billionaires and large corporations over the health and safety of everyday Americans.”

All but five congressional Republicans voted for the One Big Beautiful Bill Act, which Trump signed on July 4, 2025. Alaska’s delegation, U.S. Sens. Dan Sullivan and Lisa Murkowski and Rep. Nick Begich, voted in favor of the legislation. No Democratic member of Congress voted for it.

Included in the law is about $1 trillion in cuts over the next decade to Medicaid, the national health insurance program that provides coverage for more than 200,000 Alaskans and about 75 million Americans, including children and people with disabilities. The bill extends trillions of dollars in tax cuts for wealthy Americans and adds about $4 trillion to the national debt over the next decade, according to an analysis by the Bipartisan Policy Center.

Close to 30,000 Alaskans are expected to lose their Medicaid coverage because of the law, according to a 2025 analysis issued by Democratic members of the congressional Joint Economic Committee.

Shannon Davenport, a nurse at the psychiatric emergency room at the Providence Alaska Medical Center in Anchorage and the president of the Alaska Nurses Association, said she’s seeing an increase in uninsured patients at her workplace. For every 30 patients she’ll see in the psychiatric emergency room, about 28 of them won’t have insurance, she said. 

“As a nurse, I see it every day; I see patients come in who should have been going to their regular doctor for their diabetes or their congestive heart failure or their cancer or things like that, who are waiting because they can’t afford it,” Davenport said. “And they’re sicker, and they’re coming into our hospitals, and our waiting rooms are 70, 80 people deep on a good day.”

In addition to the Medicaid cuts, about 3,000 Alaskans had lost their Affordable Care Act coverage as of the beginning of the year after congressional Republicans didn’t extend ACA tax credits that helped Americans purchase health insurance through their state marketplace. 

The federal government began rolling out initial changes to Medicaid once the bill was signed into law, including administrative and rule changes. New Medicaid work requirements will go into effect on Jan. 1, 2027; they could result in more than 9,000 Alaskans losing coverage, according to an Anchorage Daily News analysis of a report prepared for the Alaska Department of Health. New reporting mean some recipients will have to certify their eligibility for Medicaid once every six months instead of annually, and some will have to prove they’ve been involved in what the federal government calls “community engagement” — working, going to school or volunteering — for 80 hours each month. Civil rights advocates argue that reporting requirements are used to burden enrollees with red tape in an effort to deny benefits to people who are entitled to them.

The loss of both ACA and Medicaid coverage for residents statewide places a financial strain on hospitals as an increased number of uninsured patients are forced to turn to emergency departments for treatment that they can’t afford elsewhere, Lee and Davenport said. 

Medicaid cuts have left hundreds of hospitals across the country at risk of closing, reducing services or laying off workers, including Ketchikan Medical Center and Fairbanks Memorial Hospital, according to a Public Citizen report from the end of March.

A 2025 report from the University of North Carolina’s Sheps Center for Health Services Research  said that medical facilities at risk of closing included Ketchikan Medical Center, Providence Valdez Medical Center, Providence Seward Medical Center, Providence Kodiak Island Medical Center, and Cordova Community Medical Center. 

In April, Alaska’s only clinic dedicated to the LGBTQ+ community closed. The executive director of Identity Alaska in Anchorage told Alaska Public Radio that the closure happened because they weren’t receiving their Medicaid reimbursements quickly enough. Last November, the only year-round medical center in Healy shuttered due to financial issues. 

The closure of any hospital in Alaska would shutter a major local employer and leave rural residents to travel hundreds of miles or more to get medical care, Davenport said. The vast majority — 82% — of Alaska’s communities aren’t accessible by road, according to state officials, and even without Medicaid cuts, residents often need to charter a plane to get to a hospital, and pregnant people leave rural communities to spend their final months of pregnancy near an urban hub for care, Lee said.

Should Ketchikan Medical Center close, Davenport said, it would not only harm the town of about 14,000 people, but it would also affect the surrounding communities that rely on Ketchikan for medical care and the 1.5 million-plus tourists that annually visit the island town.

“It’s terrifying because it is the main hospital for that region,” Davenport said. “There’s not another hospital for up to 500 miles away. It’s insane when you think about it.” 

If the Ketchikan hospital closed, residents would likely have to fly to Seattle for care, Davenport said.

Barbara Bigelow, who worked at Ketchikan Medical Center for 20 years and ended her career there as the regional vice president for quality and patient safety, said its closure would be disastrous, especially for people who go into labor and don’t have time to get to a hospital farther away.

“We’ve survived a lot of cuts over the years, but cutting Medicaid in Alaska to the bare bones is a very bad idea for population health, for women delivering babies, for our elders, our older folks,” Bigelow said during the Protect Our Care Alaska forum in April. 

“We can’t have a community without a hospital,” Bigelow continued. “I’ve said that many times, but we cannot survive as a community without a hospital.”

Instead of ripping Medicaid insurance away from a child or someone suffering from disease, society should be asking how to better protect the most vulnerable among us, Davenport said.

“These are the individuals we should be holding up and saying, You know, I’ve got you. I’m going to be there. I’m going to be there by your side. I’m going to hold your hand, and we’re going to get through this together,” Davenport said.