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Members of the U.S. Senate are rushing to pass a sweeping budget bill before the July 4th recess — a bill that would devastate Alaska’s economy, dismantle our already fragile healthcare system and harm tens of thousands of Alaskans. The “Big Beautiful Bill,” as President Trump described it, is anything but. It gives massive tax breaks to billionaires while shifting the burden onto working families, rural communities and vulnerable patients.

Make no mistake: this bill would gut the Affordable Care Act, slash Medicaid funding and force Alaska to implement costly bureaucratic hurdles that make it harder to access care. According to the nonpartisan Joint Economic Committee, as many as 33,000 Alaskans could lose their health coverage if this bill becomes law.

Hospitals across the state could be forced to absorb more than $87 million in uncompensated care. For remote and rural facilities already stretched to the brink, these cuts could lead to service reductions or outright closures.

As a nurse who has spent decades working in Alaska’s healthcare system, I’ve seen firsthand how critical Medicaid is. It provides coverage to more than 248,000 Alaskans — one in three people in our state. These aren’t just numbers. They’re veterans, new mothers, children with special needs, low-wage workers, elders, and Indigenous families. Medicaid covers 36% of Alaska’s children and is one of the largest federal funding sources for K-12 education in the nation. Chances are, someone you know relies on the ACA, Medicare or Medicaid.

This bill would also create new administrative hurdles that make it more difficult to remain enrolled in coverage. These added barriers would be especially punishing for rural and Indigenous communities, where limited internet access, postal delays, and geographic isolation already complicate access to essential services. These changes would be managed by the same state agency that was recently fined $12 million for failing to process food stamp applications. Adding more red tape to an already overwhelmed system isn’t just inefficient — it’s harmful.

The bill would also slash up to $194 million in annual federal Medicaid funding to Alaska. That level of loss would force the state into impossible choices — either raise taxes or make deep cuts to essential services like education, public safety, and healthcare.

At the same time, private insurance would become dramatically more expensive. A 60-year-old couple in Alaska, earning $82,000 per year, could see their annual premiums rise from $8,700 to more than $53,000. For many families, that price tag is simply unaffordable. As a result, an estimated 3,000 Alaskans could lose coverage altogether — not because they no longer qualify, but because they can’t pay the bill.

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Supporters of this bill claim it’s about cracking down on fraud or encouraging employment. If that were true, the legislation would include resources to help states implement changes fairly — funding for exemptions, more time for rollout, and flexibility for people impacted by disasters or job shortages. But it doesn’t. This bill isn’t designed to help people — it’s designed to kick them off.

This isn’t fiscal responsibility. It’s targeted cruelty. It punishes struggling families, burdens healthcare providers and puts lives at risk — all to give tax breaks to the wealthiest Americans.

Sens. Murkowski and Sullivan: This is your home. Stand up for the people of Alaska. Vote no on this Big Ugly Bill. Alaska deserves better.

Donna Phillips, BSN, RN, has 45 years of experience as an RN and currently serves as labor council chair of the Alaska Nurses Association Labor Program.

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