As Trump Republicans in Congress push ahead with massive cuts to Medicaid as part of their wealth-transfer legislation, health care providers met on Wednesday to warn that the cuts would have horrible consequences for Alaska, a state where about 40% of all residents rely on the program for health coverage.
The precise shape, scope and impact of the cuts have been hard for providers to nail down, but they said they’re racing to put some real-world numbers to the cuts with a study through the University of Alaska’s Institute of Social and Economic Research. Emily Nenon, Alaska Government Relations Director for the American Cancer Society Cancer Action Network, said a finalized report will be out in a few weeks. She said sharing some of the preliminary findings was critical given that the U.S. Senate is likely to act sooner.
“Now, these are from a very conservative model: Total job losses in the thousands. We’ve seen ranges of total job loss of up to 3,000 jobs from the Medicaid cuts alone,” she said, “And when you look at where Alaska falls, it is going to bear a disproportionate burden of these cuts. Now, when I say cuts, I’m not just talking about cutting money, I’m talking about cutting people.”
She and other health care providers from clinics in both Anchorage and more remote communities warned that the cuts would have a cascading array of predictably negative outcomes for nearly everyone, except the state’s wealthiest residents. A key message from the day was that, for all of Medicaid’s shortcomings, it provides people with accessible, essential and often life-saving care throughout their lives, which helps them avoid progressing into chronic and life-threatening conditions later.
Nenon also noted that the vast majority of Medicaid expenses come from a very small number of people with chronic conditions that require costly care — about 10% account for two-thirds of the expenses. There’s not much actual savings, she said, in cutting off health care to healthy working adults, who are the most likely to be affected by the legislation.
“So it’s not just about how much money is coming from the feds to the state of Alaska for Medicaid. It’s about the people that will not be able to access care,” she said, adding, “If we want to save money in the Medicaid system, we have to get to people before they develop all these chronic diseases, right? And that’s where preventive care comes in.”
And the impacts, they warned, extend well beyond the tens of thousands of Alaskans who could lose coverage under the legislation. With 40% of Alaskans on Medicaid, several providers report that about 40% of their patients are on Medicaid, and losing them would force severe cutbacks and even closures. Some health clinics, like Planned Parenthood, have warned that the cuts could force them to close their doors altogether, resulting in a loss of low-barrier and judgment-free coverage for everyone.
Similar warnings about the cascading impacts on people with private insurance were echoed at Wednesday’s meeting.
Phil Hofstetter, the CEO of Petersburg Medical Center, stated that Medicaid’s shortcomings already make things difficult for the small rural hospital, and that cuts will only exacerbate an already-troubled health care system without saving money.
“We cannot absorb the impact of massive Medicaid cuts that will hit our state if the budget reconciliation moves forward. We’re already stretching to maintain essential services with primary, emergency, and long-term care. The bill offers no solution, no assistance to our providers and our patients,” he said. “Instead, it adds layers of bureaucracy and tighter Medicaid restrictions and threatens to choke off our care entirely. There’s no real savings here.”
The cuts to Medicaid are a centerpiece of Trump’s “big, beautiful bill,” partially offsetting tax cuts that largely benefit the ultra-wealthy. As the legislation has moved through the process, the precise scope, reach and impact of the cuts has been hard to pin down. Several Republicans in the Senate have warned that such deep cuts to Medicaid would be disastrous for their states and have sought to either reverse the cuts or, more likely, include perfunctory attempts at softening the blow.
One of the latest efforts on that front is a rural hospital fund that would specifically seek to lessen the pain for hard-hit rural communities that fill conservative states. Asked about that development on Wednesday, Nenon said, “Not that confident that dancing around the edges is going to get us where it needs to be.”
She went on to question whether the cost savings are really the goal of the bill, rather than the claimed cost savings that are already falling apart under scrutiny.
“The premise of this legislation is to remove access to care, to kick people off of the rolls,” she said, noting that the state is already struggling to administer its social safety net programs and warned that adding more exemptions will only make it more complicated and put up more barriers to people receiving care. “There are a lot of exemptions talked about. People will still have to get those exemptions. Right now, it’s taking months for people to get a regular Medicaid application processed.”