The Trump Administration’s new tax and spending bill cuts hundreds of millions of dollars in funding for Medicaid. That’s likely to affect the more than 250,000 Alaskans who rely on the program.
Medicaid is a joint state-federal funded health insurance program that covers people with low incomes or disabilities. More than 70 million Americans — including children — rely on the program to get critical care. Here in Alaska, 1 in 3 residents is enrolled in Medicaid.
In Juneau, that’s going to affect the municipality-owned Bartlett Regional Hospital. CEO Joe Wanner said — in a worst-case scenario — it stands to lose between $3 to $4 million annually in Medicaid spending once the law goes into effect.
“I don’t see this as the end of Bartlett,” he said. “It might be tough for a period of time. We will survive. We will continue to provide good patient care to the residents of Juneau.”
The new law will mean that most Medicaid recipients will need to meet certain work requirements to qualify for care. It will also compel the state to increase its eligibility checks and monitoring of recipients. Those requirements are expected to begin as early as January 2027, though the state plans to apply for waivers to push compliance back to 2029.
The Alaska Department of Health retracted a recent estimate that Alaska could lose up to $500 million annually in Medicaid spending due to the cuts. Now, it’s saying the full impact of the changes is complicated to project because many Alaskans will be exempted from the new requirements. Officials say they are working on updated estimates.
Alaska has consistently ranked among the top states in the country for the highest health care costs per person, according to a 2022 study published by Health Affairs. And, a report released by the state’s Department of Labor and Workforce Development earlier this month found that Juneau had the second-highest health care costs out of more than 250 cities surveyed in the U.S.
Wanner said Juneau’s hospital will use the meantime to financially prepare for the changes and figure out what they will look like in practice.
“With everything health care, all you have to do is try to be in this position where you’re able to survive,” he said.
Last spring, the hospital faced a multimillion-dollar deficit that threatened bankruptcy. Its board controversially chose to reduce staffing and shut down multiple programs to keep that from happening.
“We’re in a much better place than we were a year ago,” he said. “As long as we keep on our trajectory, we’re able to sustain our financial viability that we’ve seen over the last 12 months, we should be able to build some reserves up to weather the storm before.”
The bill included $50 billion toward what’s called a Rural Health Transformation Program, which is aimed at offsetting the loss of Medicaid spending in rural areas. Wanner said that funding could help Bartlett. But for now, a lot is unknown.
Matt Carle, a spokesperson for the other major medical care provider in Juneau, Southeast Alaska Regional Health Consortium, or SEARHC, says it is still assessing the impacts of the bill on its services.
