Federal Government

The Alaska Department of Health said Wednesday it is still assessing how President Trump’s so-called One Big Beautiful Bill Act will affect the state’s Medicaid program. State officials say they do not have reliable estimates of how many Alaskans could lose coverage or how much the new law will reduce federal health care spending.

On Monday, the Department of Health shared a document with the Anchorage Daily News saying the bill could reduce Medicaid spending in Alaska by $300 million to $500 million per year. But the Department of Health retracted the estimate Wednesday, with a spokesperson saying the document overestimated the impact and that the figures were “not correct at all.”

“Unfortunately, some of the information it contained was based on national models that had not yet been updated and did not account for the final version of the bill passed by the Senate,” Communications Director Shirley Sakaye said.

Emily Ricci, the deputy health commissioner in charge of Alaska’s Medicaid program, said in an interview that the department’s earlier projections didn’t account for exemptions that will apply to many Alaskans that the state’s congressional delegation inserted into the bill in the final days before it passed.

“There’s a lot of research that we have to do on our end to really think about how these exemptions that are in the bill, how they align with our Medicaid population, and what our projections are,” Ricci said.

The bill creates what it calls “community engagement requirements” that require able-bodied Medicaid recipients ages 18 to 64 to work, volunteer or study 80 hours per month. Advocates say those will likely push some recipients off the program, in part because they make applying for benefits more complicated.

But Ricci said the state plans to apply for waivers that would move the effective date of the work requirements to 2029. The department plans to launch an “integrated eligibility enrollment system” in 2028 that should simplify benefits applications, Health Commissioner Heidi Hedberg said.

In addition, many Alaskans are likely to qualify for exemptions even once the work requirements take effect, Ricci said.

There’s a long list of people who would be eligible. According to a webpage the Department of Health published Wednesday, they include:

• Alaska Native people
• People with disabilities
• Children
• People under 26 who were enrolled
• People enrolled in Medicare
• Parents with kids 13 or younger
• Pregnant women
• People with serious mental illnesses, including substance abuse
• People who have another serious or complex medical condition

Residents of boroughs and census areas with high unemployment will also be exempt. Fifteen Alaska regions currently qualify for that exemption, though that could change by the time the work requirements take effect. There are additional flexibilities for seasonal workers, like fishermen, construction workers or people who work in tourism.

Alaska is insulated from some other Medicaid cuts included in the bill because it’s the only state that does not finance its program using so-called provider taxes or state-directed payments, Ricci said.

Hospitals and medical providers raised concerns in the leadup to the bill’s passage, saying Medicaid cuts could force some hospitals in rural areas to close or cut back services.

But Hedberg, the health commissioner, said in an interview that the last-minute addition of a $50 billion fund for rural health should blunt the impact on Alaska’s medical system. Over the next five years, half will be distributed equally to all 50 states, and Hedberg said the other half will be distributed at the discretion of the Centers for Medicare and Medicaid Services.

“We are one of the most rural states, and the healthcare delivery system is very different in Alaska compared to the Lower 48 so I think that we are well-positioned with this funding,” Hedberg said.

Rural health groups say they still have questions about how the money will be distributed.

One in three Alaskans is enrolled in Medicaid. The Kaiser Family Foundation estimates that the final version of the bill will reduce federal Medicaid spending in Alaska by 11%, or $1.5 billion to $2.5 billion over the next decade.

Hedberg said the state is working with a contractor to get a more accurate estimate.

Listen here:

The Alaska Department of Education and Early Development is appealing a federal decision that could cost the state $80 million – and potentially undermine equitable funding among Alaska schools. 

Federal impact aid is at the center of a dispute between the state and the federal government. It’s money that makes up for lost revenue from land that can’t be taxed, like federal, military or Alaska Native-owned land.

The state can normally use a portion of that money as part of its contribution to school districts – as long as it can prove it’s funding education equitably. That’s done through a disparity test.

The state failed that test earlier this year because the U.S. Department of Education rejected the state’s attempt to exclude funding that districts set aside for transportation from the test calculations. That means the state can’t use $80 million in federal impact aid to offset part of its obligation to school districts.

But it’s appealing that decision. In its appeal, the state argues that the federal department was wrong to count transportation funding in its test calculations. The state also asked to retake the test if the appeal fails.

Bonnie Graham, one of the attorneys representing DEED in the appeal, said in an email that it’s difficult to tell how long the case will take this early in the process, and could not comment on “potential outcomes of the pending appeal at this point.”

The federal department said in an email it will review information from the state and hopes to resolve the issue.

Financially, there are a few ways the appeal could play out. The simplest is if the appeal is successful. In that case, the state could continue to use federal dollars as part of its contribution to school districts.

But if the appeal fails, things get more complicated. Districts that qualify for impact aid would still receive that money on top of what they get from the state. And the state would need to make up for an $80 million gap in its funding. 

Alexei Painter is the director of the state’s Legislative Finance Division. Part of his role is to understand how the decision would affect the state’s budget. 

“If we fail the test under the Legislature’s budget, the state costs would go up by $80 million and then those districts would also get that $80 million,” he said. “So essentially districts as a whole would get about $80 million more.”

But some individual districts would get less, he said. 

Painter said that’s because the Legislature sets aside an open-ended amount of money for education funding. It’s basically however much is needed to meet the state’s statutory obligation to districts. He says in this case, districts get whatever the state owes them, plus the federal funds.

But Gov. Mike Dunleavy vetoed more than $50 million in education funding earlier this summer. If state legislators uphold the veto, Painter says that changes education funding from something open-ended to a fixed amount of money. The state would still need to make up the $80 million dollars, but it would have to do so by cutting education funding across the board.

“There’s only a fixed pot of money,” Painter said. “Raising the amount the state owes by $80 million means that all districts will essentially see their amount of aid reduce.”

The finance division estimates the state would have to reduce funding equal to an additional $319 cut to the state’s per-student allocation. That, along with the governor’s veto, would leave districts with only a $181 increase to the base student allocation this fiscal year.

That doesn’t mean that all districts would lose money. The division’s estimates show some districts, like the Fairbanks North Star Borough School District and Bering Strait School District, would receive enough federal impact aid that they receive more money overall – up to millions of dollars more.

Other districts like Anchorage and Kodiak would receive some impact aid, but it isn’t enough to offset the reduced state funding.

And for the 15 districts that don’t receive any impact aid, it would mean less state funding with no federal funds to fall back on. The Juneau School District is one of those districts. It could lose more than $2.5 million without any federal funding to make up for the loss. 

Juneau School District Superintendent Frank Hauser said it’s hard to figure out how things will shape up.

“It’s so difficult to even try to speculate as we’re going through and trying to figure out what could happen, because none of these situations are good for the students,” he said.

Hauser said he’s more concerned about other funding uncertainties that have cropped up in recent months. On top of Dunleavy’s education funding veto, DEED is proposing a regulation change that would further limit local contributions from municipalities to school districts.

On the federal side, the U.S Department of Education blocked millions in grants for migrant education, English language learners and more to the state.

Hauser says the district could lose more than $8 million from those actions.

The appeal process still has to play out. And the state has been successful in a similar appeal before – it successfully appealed a failed test in 2022. 

But at that time, Painter said the state didn’t find out until the end of the fiscal year. He said a similar timeline and a failed result could make things difficult for the state and districts. For example, districts that would receive more money may not have enough time to spend it, and may have more money in savings than state law allows.

In the meantime, Painter said the state is distributing funds to school districts as if it hasn’t failed the test.

Correction: This story has been updated to reflect that school districts will potentially be impacted by a failed appeal, not states.

Thousands of Alaskans are still caught in backlogs as they try to get government benefits intended to help people facing disabilities and poverty.

That’s despite a yearslong effort by state officials to keep up with paperwork. And some say the problems will only get worse with new federal work requirements for Medicaid.

One Alaskan caught in the quagmire is Juneau resident Joy Lee.

Several times a month, Lee faces unimaginable pain.

“All of a sudden you’ve got half your mouth is a toothache, and your eyeball’s falling out of your face, and your face is on fire, and you’ve got a severe earache — but it’s not real,” she said in a recent interview.

Lee is 63. She has multiple sclerosis, a treatable, but ultimately incurable, autoimmune disease. One of her symptoms is a chronic pain condition known as trigeminal neuralgia.

For a while, she said, she could manage it. At one point, she recalled, she had to be on a work call while lying on the floor during an episode. But eventually, it got to be too much.

Lee exited the workforce in 2007, after working since the age of 14. She qualified for disability payments from Social Security. She started receiving state-administered aid from Adult Public Assistance and the Supplemental Nutrition Assistance Program, or SNAP.

These days, from her Juneau apartment, Lee spends a lot of time keeping up with all the paperwork — saving digital files, paper backups, all her receipts. She likes to think she’s on the ball.

So Lee was shocked when the state said she wasn’t.

“I sent in all my paperwork, and then 30 days later, I got a notification saying that they didn’t get my paperwork and I was having all my benefits cut,” she said.

Lee called the Division of Public Assistance, the state agency that handles Medicaid, SNAP, Adult Public Assistance and other benefits programs.

“They looked at my paperwork and said, ‘Yeah, we’ve got all your paperwork, but it’s an automatic letter, because there’s no agents to do the cases,'” she said.

Lee called it a “paperwork nightmare.” And she’s far from alone.

It’s a problem that first gained public attention thanks to reporting by KTOO beginning in 2022. Despite court orders, lawsuits and efforts by state officials to address the issue, it persists.

Lee’s struggle is “a variation of a story that we’ve heard many times,” said Nick Feronti, an attorney with the Northern Justice Project, which has sued the state on behalf of Alaskans unable to access social safety net programs like SNAP, Medicaid and Adult Public Assistance. It’s hard to see evidence that things are improving, he said.

“They are either getting worse or maintaining, and there has not been much positive news, which is very sad for the residents of our state,” Feronti said.

Feronti feels like lawmakers and the governor haven’t prioritized eliminating the backlog, he said. He contrasted that with the attention state leaders give to the Permanent Fund Dividend.

“If our PFDs were delayed, people would be in the streets, and the executive branch of our government would take notice and fix the PFD delays right away,” he said. “But I think that because this is happening to poor people or to disabled people, they are pushed to the margins of our society, and they are neglected.”

As of the latest report on July 1, the state is only processing about half of Alaskans’ applications for SNAP benefits on time. But state officials say they are making progress — in June, the state told a federal court its SNAP backlog declined by 16%.

“I’m here every day working to solve the problem,” Division of Public Assistance Director Deb Etheridge said in an interview. “I have just an amazing group of eligibility technicians and amazing, you know, tremendous support from the commissioner’s office and the governor’s office to work towards (a) solution.”

But nearly 4,000 Alaskans are still caught in the SNAP backlog, and nearly 800 applications for the Adult Public Assistance program have languished for more than a month.

In the state’s Medicaid program, the backlog is much larger. Nearly 30,000 Alaskans are awaiting delayed decisions on their applications, according to state data provided by Feronti.

Etheridge emphasized that many stalled Medicaid applications are likely duplicates, and she said people with pending applications are still able to access medical care.

“We have a team that works with providers to receive that information and process anything that’s identified as urgent and emergent,” she said. “We’re really trying to work on all fronts.”

On average, it now takes 45 days for the state to process SNAP applications, roughly two weeks longer than federal law requires. That number has risen this year, due in part, Etheridge said, to the division’s decision to prioritize older cases.

“We want to get everybody closer to 30 days. We don’t want to have those aging,” she said.

But Etheridge says people caught in the backlog and people like Joy Lee, who are at risk of losing them, do have options. One is to file a request for what’s known as a “fair hearing.” That’s an option for anyone who’s received an adverse decision from the Division of Public Assistance, whether related to SNAP, Medicaid, heating assistance, Adult Public Assistance or something else.

The division’s call center can help people apply for fair hearings, Etheridge said. Alaskans can also request them via email.

Feronti, the attorney, said Alaskans having trouble accessing SNAP and Adult Public Assistance can contact his firm for help.

The Division of Public Assistance is also hiring aggressively and having some success filling positions, Etheridge said. But despite her best efforts, she said she’s not sure when the division will be able to catch up.

“We’re still working our way out of it, and so I would be naive to say a date,” Etheridge said.

This year’s state budget funds 15 new benefits processing jobs, but staffing levels are still roughly 20% lower than they were before lawmakers and the governor cut more than 100 positions in 2021, according to state budget documents.

Benefits processor and state employee union official Billy Stapleton Jr. said that’s the root of the problem: not enough staff.

“There’s no Band-Aid fix,” he said. “We need a permanent solution to do this job correctly, and we just simply need more workers.”

In the coming years, Stapleton said, there’s reason to believe the problem will get significantly worse as a result of Medicaid changes included in President Trump’s so-called “big, beautiful bill.” Once its provisions take effect in the coming years, it will require some Medicaid recipients to prove they’re working or volunteering — and file forms with the state twice a year rather than annually.

That means even more paperwork.

For now, Joy Lee said the Division of Public Assistance has told her she won’t be cut off. At least, not this month.

But thousands aren’t so lucky, she said. Lee wishes more Alaskans would stand up and tell their leaders it’s unacceptable, she said.

“You gauge a country by how it takes care of the least of these,” she said, referencing a passage from the Bible. “When our country all of a sudden doesn’t care about anybody … it just breaks my heart.”

The U.S. Department of Agriculture axed a program this week that was supporting farmers and food producers, including those in Alaska.

The department created the Regional Food Business Centers program in 2023 to strengthen local food economies. But on Tuesday, it abruptly ended that program, which was originally funded with pandemic relief money through the American Rescue Plan Act. USDA officials said in a press release there was no long-term way to finance it.

Robbi Mixon is the executive director of the Alaska Food Policy Council, which was in charge of the program locally. Mixon says this decision pulls back over $6 million in investment for Alaska, where the majority of food is imported and many villages are not on the road system.

“This was a chance for real economic investment into our food and farm businesses and fishers,” Mixon said. “It was a way to attract more investment as well, in terms of grants and loans and things like that. So it’s just really sad to see it all go down like this.”

A dozen business centers across the country were part of the program. Each one worked to allocate grants to food producers and farmers and help them with grant writing, marketing and business planning.

The Alaska Food Policy Council was working within one of those centers. Mixon says it was a strategic effort to build coordination and long-term infrastructure across Alaska’s food sectors.

“The program was tailored to address specific challenges in Alaska,” Mixon said. “So, our huge geography, our huge transportation and logistic costs, and our community size.”

The council planned to award grants to over 50 food and farm businesses across Alaska. But as they approached the time to award grants last winter, the Trump administration froze the funding, and they had to pause their grant program.

The Department of Agriculture stated in its release that it will honor existing commitments to farmers and food businesses. But in Alaska, Mixon says, almost none of the businesses had an official contract yet – they were only preparing for that collaboration to begin.

“We were working with an organization that was looking to set up more fresh produce markets in rural Alaska. We were working with an organization that wanted to provide technical assistance for home-based food businesses,” Mixon said. “And we did have tribal partners as well.”

Still, Mixon says the food council will use its volunteer board and statewide working groups to advocate for investments and build stronger food systems for all Alaskans.

The fate of Alaska’s smaller public radio stations is in doubt after Congress passed a bill to defund the Corporation for Public Broadcasting.

The House passed the bill overnight Thursday, 216-213. Alaska Congressman Nick Begich voted yes. That came less than 24 hours after the bill cleared the Senate, despite opposition from Sen. Lisa Murkowski.

Murkowski voted for several amendments from Democrats to preserve part or all of $1.1 billion for public broadcasting. All of them failed.

Conservative Republicans said they wanted to defund NPR in particular, because they consider its content too left-wing.

Murkowski then offered an amendment to just defund NPR and keep the money flowing to rural stations. That amendment failed, too, with Murkowski and Sen. Susan Collins of Maine as the only Republicans to support it.

“Even though what I offered was exactly what my colleagues were calling for,” Murkowski said. “Every time they spoke about public broadcasting in the negative they used words like, ‘It’s a radical liberal agenda.’ And their reference was not to the emergency early warning system. It was not to the children’s TV programming.”

Now, Murkowski said, she’s focused on what Alaska’s rural stations need to stay on air, and she’s not seeing a lot of opportunity. CPB is the main source of funding for many of Alaska’s 27 public radio stations and a significant contributor to Alaska Public Media’s budget, too.

“I have no surety that these small stations that provide such important connections within their community are going to be able to stay afloat,” she said.

The general managers of rural stations in Alaska have warned about that, too, though some are still holding out hope for other funding.

One source might be a $10 million fund at the Interior Department, in the Bureau of Indian Affairs, that assists tribal stations. Murkowski said a dozen Alaska stations might qualify.

“But when we’ve talked to folks over at Interior about how this is all going to work, it’s truly radio silence,” she said. “And I don’t think they’re denying us information. I think they truly do not know.”

Even if they are eligible, Murkowski said Alaska stations would have to compete with stations in other states for a share of the $10 million and can’t bank on getting any of it.

Though the Senate has now voted to claw back two years of funding for the Corporation for Public Broadcasting, the corporation still exists. Congress could appropriate new money for it to send to rural stations. Murkowski said that would be a tough sell to her Republican colleagues.

“I will just remind you of that vote that you saw last night on my amendment,” she said. “It was made very, very clear — and I don’t have the tweet in front of me, you’ve seen it — but the president said … basically, ‘Anybody who wants my endorsement, you better not support the Corporation for Public Broadcasting.'”

Murkowski said she hasn’t given up on sending money to CPB. She hopes public radio and tv supporters around the country are “going to start weighing in with their lawmakers, Republicans and Democrats, and saying, ‘Hey, how are we going to keep this alive?'”

Sen. Dan Sullivan didn’t grant an interview request to explain why he voted against Murkowski’s amendment. He has described himself in letters to constituents as a supporter of funding for public radio stations. In 2020, he accepted a “champion of public broadcasting” award from America’s Public Television Stations.

A Sullian spokeswoman said by email that Sullivan has warned for years that NPR is biased, but that he is talking to the Trump administration about finding support for rural Alaska stations.

Having cleared both chamber of Congress, the rescission bill heads to President Trump to sign into law.

Editor’s note: Alaska Public Media receives funding from the Corporation for Public Broadcasting. This story was written and edited within the Alaska Public Media newsroom, and no Alaska Public Media executives outside the newsroom reviewed it before publication.

This story and headline have been updated to reflect the bill’s passage in the House.

The U.S. Senate has passed a bill to defund the Corporation for Public Broadcasting and cut billions from foreign aid programs.

Sens. Lisa Murkowski and Susan Collins of Maine were the only Republicans who voted no.

Before the bill passed, Murkowski offered an amendment to try to preserve grants to local stations. She read her colleagues a text she’d received from the general manager of KUCB in Unalaska after Wednesday’s 7.3 magnitude earthquake. When the tsunami sirens sounded in Unalaska, the loudspeakers directed people to tune into the local radio station, the text said, and Murkowski relayed that KUCB kept the community updated on air and social media, until the all-clear.

“They say, ‘This is the work that we do to keep Unalaska safe,’ And it’s only possible with federal funding,” Murkowski said, as the debate stretched into the wee hours of Thursday. “Mr. President, I have an amendment that protects public media.”

Sen. Eric Schmitt, R-Mo., argued that public media doesn’t play a vital role in disasters.

“I know that’s a scary situation in Alaska, but the good news is FEMA money will be there for these sort of alerts,” he said.

Murkowski’s effort failed by a vote of 51 to 47.

Sen. Dan Sullivan voted against the public media amendment and helped Republican leaders pass the $9 billion rescission package that’s a high priority for President Trump.

The bill goes next to the House, which has to vote to approve the Senate changes. The bill expires if not passed by Friday night.

Editor’s note: Alaska Public Media receives funding from the Corporation for Public Broadcasting. No Alaska Public Media executives outside the newsroom reviewed this story before publication.