Bartlett facing short- and long-term setbacks due to federal budget bill, hospital’s CEO says
- Mark Sabbatini
- Jul 23
- 3 min read
Some ACA coverage will be affected starting Jan. 1, but the most significant Medicaid changes won’t happen for about 18 months
The ill effects of the "One Big Beautiful Bill Act" for Juneau residents will begin with milder setbacks for some patients before the most severe impacts start to hit in about 18 months, Bartlett Regional Hospital’s chief executive officer said Tuesday.
"The biggest thing I see as being an issue for us is there are some of the (Affordable Care Act) subsidies that will be impacted here shortly," he said. "So starting January 1 we could see a decrease in customer insurance."
Beyond that it will be about 18 months until the biggest changes to Medicaid coverage take effect — and some exemptions that apply to Alaska due to its rural and tribal communities will reduce the harm of those cuts somewhat, he said.
About 10 million people nationwide are expected to lose health coverage under the bill passed by Congress that codifies much of President Donald Trump’s stated domestic policy agenda, according to a Congressional Budget Office forecast published this week. The bill cuts $1 trillion in federal health care spending and adds $3.4 trillion to the national deficit during the next decade by also including $4.5 trillion in tax cuts that fiscal analysts say primarily benefit the wealthy.
The Alaska Department of Health on Monday projected a cut of up to $500 million in its annual $2.7 billion Medicaid allocation, but top leaders on Wednesday told the Anchorage Daily News that figure was overstated — without providing a specific revised amount. The leaders said the original figure did not include exemptions to nationwide cuts that apply to state and tribal entities that were added to the bill by Alaska’s congressional delegation.
Wanner, during a meeting of Bartlett’s board of directors Tuesday night, said hospital administrators met during the weekend with a staff member for U.S. Sen. Lisa Murkowski (R-Alaska), and a major takeaway "is Alaska kind of is insulated compared to other states."
"While the impact of the bill appears to be less for Alaska than other states, I have no doubt that we will be impacted," Wanner noted in a memo presented to the board as part of his report. "The good news, as I see it, is that we have time to develop plans to address some issues while others we will need to start working on immediately."
One advantage the hospital has as it tries to adjust is its financial situation is greatly improved compared to a year ago, Wanner said. Bartlett found itself facing a fiscal crisis last spring after an average loss of $1 million a month dating back to mid-2020, but managed to show an operating profit during the latter part of 2024 after making a series of staff and program cuts.
"Through the first 11 months of fiscal year 2025 we had an operating margin of 4.3%, above our goal of 3%," Wanner wrote in his memo. "The goal was set based on industry standards and is seen as the rate that enables hospitals to be successful in replacing capital and retaining staff. To fully appreciate the year-to-year change in our financial health, when we look at the net income for Bartlett we see a $14.7 million positive swing, from a loss of $6.7 million last year to a gain of $7.9 million this year. This puts us in a better position to address the impact of this bill."
Cuts to the needs-based Medicaid program — in contrast to Medicare, which covers people 65 and older or younger people with disabilities — is the biggest healthcare concern expressed by critics (and some supporters) of the budget bill. Alaska legislators said during this year’s session it’s not financially feasible for the state to make up for the reduction in federal dollars to ensure all enrollees maintain their coverage.
Strong supporters of the bill, including Sen. Dan Sullivan (R-Alaska) and Rep. Nick Begich III (R-Alaska), say it helps ensure the long-term sustainability of Medicaid by imposing eligibility standards such as work requirements for able-bodied people that begin in 2027.
About 250,000 Alaskans — roughly one-third of the state’s population — are enrolled in Medicaid, according to the Department of Health. Of those enrolled, about one-third are Alaska Natives. One of the exemptions added by the delegation exempts Natives and certain seasonal workers such as fishers from the work requirements.
• Contact Mark Sabbatini at editor@juneauindependent.com or (907) 957-2306.
