Healthcare cuts threaten Sullivan's reelection chances in Alaska

Alaskans have been hit hard by the healthcare cuts in the One Big Beautiful Bill Act and lapsed ObamaCare subsidies, presenting a prime target for Democrats seeking to oust Republican Sen. Dan Sullivan from office.

A Democratic ad campaign released late last month accused Sullivan of voting to raise health insurance premiums in Alaska by more than $1,800 on average, referring to his votes against Democratic bills that would have ended the government shutdown in exchange for extending Affordable Care Act (ACA) tax subsidies.

When former Alaska Rep. Mary Peltola (D) launched her Senate campaign earlier this year, her announcement took a swipe at Sullivan's support for the GOP megabill, pointing to a think tank's projection that it would take healthcare coverage from millions of Americans.

Sullivan appears well aware of his vulnerability on the issue.

In the past month, he has broken with the GOP twice to side with Senate Democrats on health provisions. The Alaska senator voted for an amendment sponsored by Senate Minority Leader Chuck Schumer (D-N.Y.) opposing any funding bill that failed to lower out-of-pocket healthcare costs. Sullivan also voted for another amendment sponsored by Sen. Jon Ossoff (D-Ga.) that will address insurers delaying or denying care.

Sullivan was also among four GOP senators who broke with the party and voted to extend the ObamaCare tax credits late last year, after previously voting against similar measures. The bill did not reach the 60-vote threshold needed to pass.

"Given how many times he has voted for legislation or amendments that would either reduce healthcare subsidies for Alaskans or otherwise increase healthcare costs, the damage has largely been done," John-Henry Heckendorn, partner at the cross-partisan campaign management firm Ship Creek Group, said.

Ship Creek Group worked on Peltola's first House campaign but isn't working on her Senate campaign.

"It's one thing to vote on your principles. It's another thing to follow the party line until you feel like you're in danger and then try to cover your tracks," he said.

Heckendorn added that healthcare was "absolutely" an issue that could sway Alaskan voters.

"We have some of the highest healthcare costs in the country, and our marketplace has, I believe, some of the most expensive premiums. And there's some studies that show that healthcare costs for Alaskans have increased by over $1,000 in the last year," Heckendorn said.

At the beginning of the year, initial figures indicated about 3,000 Alaskans had dropped out of the ACA marketplace after the subsidies expired, representing an 11 percent decrease that's expected to rise as enrollees struggle to keep up with higher premiums.

"Alaska is facing a loss of a lot of federal funding because of the [cuts to] Medicaid through the HR.1 legislation last year and then also the expiration of the premium tax credits, and it adds up to quite a lot of money in terms of funding losses," Sara Collins, senior scholar at the Commonwealth Fund, told The Hill.

"It also has trickle-down effects for the broader economy," Collins added. "On the healthcare side, all of this supports healthcare in Alaska, right? I mean, all the Medicaid, dollars, the premium tax credits … it supports coverage, but it also just supports the overall health system and the state."

In the Commonwealth Fund's 2025 Scorecard on State Health System Performance, Alaska ranked 38 out of all 50 states in terms of overall performance.

When reached for comment about his recent votes, Sullivan's office said the senator had a "track record of voting with colleagues on both sides of the aisle when it's good for Alaska."

"One of Sen. Sullivan's priorities is getting healthcare dollars out of the hands of insurance companies and into the hands of the people," it said in a statement.

"While he remains a vocal critic of Democrat one-size-fits-all federal policies that have historically crashed Alaska's insurance market, Sullivan repeatedly voted to extend the ACA enhanced subsidies to protect everyday Alaskans from the cliff Democrats imposed when they allowed the subsidies to expire in 2025."

While most election forecasters still favor Sullivan to prevail in November, Peltola outraised him in the first quarter and is beating him in recent polls — by nearly 7 percentage points in a late April poll by Alaska Survey Research.

Sullivan has argued that some of his other efforts to protect healthcare for Alaskans have been defeated by Democrats, such as an amendment to the One Big Beautiful Bill Act.

While Alaska doesn't rank last in terms of healthcare — that designation goes to Mississippi — it does have challenges that other states don't have, being the largest state by area in the U.S.

"The biggest sort of defining factor in really understanding the economics of healthcare there is it's a really, really big state, but it's also highly dispersed in terms of its population," Scott Leitz, vice president of the healthcare programs department for NORC at the University of Chicago, said.

These logistical hurdles make recruiting and retaining healthcare providers more difficult. The state also has a very concentrated health insurance market, with Premera Blue Cross Blue Shield of Alaska controlling more than 70 percent of the state's active insurance market.

"So, all of that kind of combines up into creating an environment where costs are somewhat higher and access to care can be more of a challenge than in some of the more highly concentrated population states," Leitz added.

Leitz noted that Alaska also has one of the highest concentrations of federal employees, estimated at 6.6 percent of the workforce in 2024, making federal moves more consequential.

"Changes that occur at the federal level can have a somewhat larger impact in the state, depending on what the changes are, just because of that weird diversity that the state has in terms of its payers," he said.

Six months out from Election Day, Heckendorn said Sullivan's recent votes presented a new political danger: being perceived as changing his mind for political expediency.

"Alaskans can't get the dollars back in their wallets that they've had to spend on inflated healthcare costs as a result of his votes," he said. "All that damage is done, but now he's kind of admitting that those votes were never about principle in the first place."