Medicaid coverage throughout the country will change starting in 2027 due to President Donald Trump’s “Big Beautiful Bill,” which the U.S. Congress passed in July. But in Alaska, experts say those changes will look very different from other states.
Emily Ricci, the deputy commissioner of Alaska’s Department of Health, spoke about what the state can expect with the new Medicaid rules Wednesday on the program “Line One.” She said Alaska’s federal match for funding the insurance program won’t change because it doesn’t rely on two funding mechanisms impacted by the bill.
“Alaska is not impacted by reductions to those programs that were contained in the reconciliation bill,” Ricci said. “And that's important to understand, because every other state will likely experience some form of reduction in the kind of federal share of Medicaid dollars that is going to their state associated with those two programs.”
In 2024, the federal government paid about three-quarters of Medicaid spending in Alaska overall. It’s health insurance for people who are low-income or disabled.
Ricci said one major change is that some able-bodied adults on Medicaid will need to fulfill so-called “community engagement requirements” to keep their coverage. She said a variety of activities will be allowed.
“They include things like education, so being a student, being in a vocational school or technical school,” she said. “They involve volunteering, and they also involve employment. There's also opportunities that are in the bill for individuals who engage in seasonal employment.”
She said community engagement requirements won’t apply to several groups of people like pregnant people, people who are Alaska Native or American Indian or parents with young children under 13. She said communities will also be able to apply for “hardship exemptions” if they have high enough unemployment rates.
