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There is no question: the federal budget reconciliation now under Senate review would severely harm Alaskans, especially in rural communities. As CEO of one of Alaska’s last three community-owned critical access Hospitals, I see the consequences firsthand when people lose healthcare coverage. This bill adds layers of bureaucracy and new Medicaid restrictions that threaten to choke off care entirely. Fortunately, our senators can choose to block it.

If the Senate rushes this legislation through, an estimated 33,918 Alaskans will lose their health insurance. One in five of these will lose coverage they have now through the Affordable Care Act, while the remaining 80% will lose their Medicaid coverage. Many people have already written powerfully about the effects this will have on Alaskan families, given that over one third of births in our state and over 100,000 Alaskan children are currently covered by Medicaid.

I have worked for over 30 years to improve health outcomes for rural Alaskan communities in both Northwest and Southeast Alaska. All over this state, the truth is that all Alaskans depend on people who depend on Medicaid. They are our relatives, our friends, our childcare providers, the people who fish and hunt and farm to feed us. They are our neighbors. Regardless of what talking points come out of Washington, D.C., the data is clear: the majority of the people covered by Medicaid already work full-time. And when they are uninsured, the impact ripples across entire communities.

Rural hospitals already face constant challenges and delays with Medicaid eligibility and redetermination. We already absorb the cost of care for patients stuck in Medicaid eligibility limbo – the extra work needed just to help Alaskans navigate a system designed to deny care, not deliver it. This bill does not save on costs or address health problems. It simply threatens to shift even more costs onto the shoulders of rural hospitals like ours.

Petersburg Medical Center is the only source of primary, emergency and long term care in our borough. As in many rural communities, our hospital is also one of the primary employers and sources for job training. When our patients lose coverage, the health care they need doesn’t stop. That care just becomes more expensive and — when delayed — more desperate. ER visits. Inpatient stays. Medevac flights. Interventions that cost ten times what timely local care costs.

Covering costs at the local level for people losing their coverage under this legislation will force hospitals like ours into a budget crisis. And once a health care service goes away in a rural area, rebuilding it is next to impossible. Skilled professionals move away from the region. Without regular use, equipment and infrastructure degrade. People are forced to bear the cost of seeking care away from home, while healthcare becomes less local, more expensive, and less available in the moment you need it. As Alaskans, we have already seen this.

Rural hospitals and the communities we serve need support, not even more barriers to care. I join my colleagues across the state in urging Sens. Sullivan and Murkowski to block Medicaid cuts that would result from pointless bureaucratic red tape.

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Philip Hofstetter, AuD is the CEO of Petersburg Medical Center, an independent community critical access hospital serving Petersburg Borough in Southeast Alaska.

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