Don't let paperwork strip Alaskans of health care

News-Miner opinion: Congress is charging ahead with a reconciliation bill so sprawling and fast-moving that even seasoned policy experts can't fully predict its consequences. But one thing is clear: This bill could affect Alaska's health care system drastically — and in ways that aren't fully understood.

While it doesn't directly cut Medicaid for seniors, children or people with disabilities, it's still a deeply concerning overhaul. The primary impact in Alaska would fall on working-age adults in the Medicaid expansion population — people who often live paycheck to paycheck and have no other health insurance options. Depending on how rigid the new work requirements and administrative hurdles turn out to be, approximately 10,000 and 38,000 Alaskans could lose coverage.

That's not due to better health or higher income — it's due to paperwork. Verifying eligibility every six months, navigating exemptions, proving hours worked — all of it will fall to a state health department already operating under strain. Many hospitals and rural clinics will see more uninsured patients and more uncompensated care. That's a recipe for a weakened health care infrastructure, particularly outside urban hubs. A proposed rural hospital fund is in the works, and it's our hope that the amount is large enough to meet Alaska's needs.

This isn't a clean policy debate, however. It's a high-speed game of chicken with Alaska's safety net in the balance.

Even state officials aren't sure what provisions will ultimately land in the final bill. And with the reconciliation bill's momentum driven by unrelated provisions, including major tax and budget items, it's more likely than not that the package will pass.

That's why Alaska's U.S. senators must act with urgency. This isn't about partisanship. It's about doing the work.

Sen. Lisa Murkowski has a proven track record of independent leadership and a deep understanding of the stakes for Alaska. Sen. Dan Sullivan, who has a long record of working with Alaska's health care systems, is pushing for Alaska-specific provisions. Together, the senators present a united front to fight for provisions to protect rural hospitals, shield providers from unfunded mandates, and prevent thousands of working Alaskans from falling through the cracks.

The reconciliation bill is likely to pass. That doesn't mean Alaska has to take it lying down. Our senators continue to fight to shape the final version — a version that ends up benefiting Alaska and its residents.