For nearly a third of Alaskans, Medicaid isn’t an abstraction. It’s how they see a doctor. State health data shows 199,576 Alaskans enrolled in the program. As of 2024, it covered 57 percent of Alaska’s children, 35 percent of adults and 15 percent of seniors, leaving few states with more riding on last year’s rewrite of federal health law.
That law, the “One Big Beautiful Bill,” includes nearly $1 trillion in Medicaid cuts between 2025 and 2034, according to the Congressional Budget Office. Senator Dan Sullivan (R-AK) was one of 51 senators who voted to pass it in July 2025, and he wasted no time declaring victory. “It’s a big win for our rural hospitals and health care as well,” he told Alaska’s News Source after the vote.
The numbers tell a different story. The health care changes passed by Congress, including the One Big Beautiful Bill, could cost roughly 36,000 Alaskans their coverage, according to estimates from the Joint Economic Committee. And losing coverage doesn’t make medical bills disappear. Uninsured Alaskans tend to turn to emergency rooms more often, driving up costs and wait times at hospitals across the state.
Sullivan has brushed those concerns aside. Responding to questions about Alaskans who could lose Medicaid under the law’s new work, study and volunteer requirements, he said that “that is not a Medicaid cut — that is a choice from that individual.” It’s a tidy line, but it offers little comfort to Alaskans who lose coverage because they couldn’t keep up with the paperwork.
In an op-ed published shortly after the bill was signed, Sullivan praised the legislation and said Senate Democrats had stripped out a provision he wrote to help Alaska’s rural hospitals. He also wrote, “Not one dollar in Medicaid benefits was cut for Alaskans.” This is despite the CBO score showing a $1 trillion cut to Medicaid nationwide.
But Medicaid isn’t the only health care coverage where Alaskans are being squeezed. In 2025, roughly 28,000 Alaskans bought private insurance through the Affordable Care Act marketplace. Enhanced tax credits that lowered premiums for those enrollees, and expanded eligibility to people earning more than 400 percent of the federal poverty level, expired at the end of last year. Sullivan voted against legislation that would have extended those credits several times last fall.
Without the subsidies, the average premium Alaskans pay after tax credits has jumped 54 percent since the start of the new plan year, according to CMS open enrollment data for 2025 and 2026. That increase lands on a state that already pays some of the highest insurance rates in the country.
Sullivan wants Alaskans to call this a win, but for many families, the reality is lost coverage or paying more for what’s left.
