Democrats Hope Gop Health Care Cuts Will Put Alaska, And The Senate, In Play

If Democrats retake the Senate in this year’s elections, Alaska’s high health care costs could be the reason.

Democrats face a tough map as they look to win the four seats they need to claim the majority and will have to win some long-shot races to get there, like that of second-term GOP Sen. Dan Sullivan.

But they have reason to believe, from Sullivan’s own testimony and voting record, that Alaskans might be receptive to a message blaming rising health insurance premiums and pending Medicaid work requirements on Sullivan and his party.

“Alaskans already pay more for health care than the Lower 48, and DC politicians are making it worse — cutting care and raising costs for tens of thousands of our neighbors to cover tax breaks for their biggest donors,” said Sullivan’s Democratic opponent, former Rep. Mary Peltola, in a statement.

Sullivan told POLITICO he’s aware of ads targeting his July vote for President Donald Trump’s One Big Beautiful Bill Act, which cut taxes and paid for it by reducing spending on Medicaid, the federal-state insurance program for low-income people. He sees the ads as “a bunch of bullshit” because Democrats blocked his effort to add language to the bill that would have shielded Alaskans.

In December, however, Sullivan himself said he was worried about another of the GOP’s decisions, to allow Obamacare subsidies to expire and let health insurance premiums spike. That month, Sullivan broke with fellow Republicans to back Minority Leader Chuck Schumer’s bill to extend the subsidies. The other Alaska Republican in the Senate, Lisa Murkowski, who’s not up for reelection, also voted for the bill, joining only two other Republicans. “My state’s hurting on this,” Sullivan told POLITICO at the time.

The Schumer bill failed and the subsidies expired, sending premiums up for 27,000 Alaskans, nearly 4 percent of state residents. Alaska has a higher cost of living than most other states and has seen premiums rise more as a result. Middle income Alaskans who’ve lost subsidies altogether have seen bills quadruple. Overall rates were projected to more than double in Alaska, according to KFF, a nonpartisan health policy think tank.

More than 3,000 Alaskans have dropped off the Obamacare rolls as of January, an 11 percent decline, with more expected as high premiums sink in.

Though the campaign season is just getting underway, outside groups backing Peltola have already spent at least $750,000 on ads pressing Sullivan on his health care positions, according to data from AdImpact.

Though Sullivan voted to extend the Obamacare subsidies — he said at the time he wanted a compromise — Democrats hope voters will see it as a bid to inoculate himself from the political consequences of a Republican Party decision to let the subsidies expire. Sullivan had rejected multiple attempts by Democrats to extend Obamacare subsidies prior to voting for the Schumer bill.

Sullivan’s also vulnerable, Democrats believe, because he supported the One Big Beautiful Bill Act. It cut more than $1 trillion from Medicaid, which about a third of Alaskans rely on. That’s a greater percentage than in all but two other states, New Mexico and California.

Sullivan said he and Murkowski sought provisions in the bill to boost Medicaid payments to Alaska, but the Senate parliamentarian said they violated the budget rules governing the legislation.

“They went line by line through that bill, and if it benefited Alaska, they went and tried to strip it,” said Sullivan, arguing the parliamentarian would not have ruled if Schumer hadn’t called the provisions to protect Alaska a “polar payoff” and demanded they be removed. Sullivan’s campaign has noted that Peltola is in the party that thwarted his and Murkowski’s gambit.

Still, Alaska, like everywhere else, will have to comply with new requirements that Medicaid recipients work, volunteer or go to school at least 80 hours a month starting next year. That’s expected to cost some their insurance and also pose new administrative costs for states.

Sullivan has touted exceptions for Alaska Natives and people in high unemployment areas, as well as the Rural Health Transformation Program that Republicans created with the law to help states cope with the Medicaid cuts.

That program allocated $1.4 billion for Alaska, more per capita than any other state and the second most overall.

“The entire state of Alaska is considered rural, so our whole state is going to be able to benefit from those dollars,” said David Wilson, director of public policy at the Mat-Su Health Foundation, which co-owns a regional hospital. Wilson, a Republican, previously was a state senator.

“Our federal delegation has done a good job at getting us carve outs,” he added, saying that Sullivan and Murkowski have gone to bat for health care in the state.

Beating Sullivan won’t be easy. The state has a decided Republican lean.

Sullivan crushed political newcomer Al Gross in 2020 to win a second term, and earlier won a nailbiter over incumbent Democrat Mark Begich in 2014 after blasting Begich for voting for Obamacare in ad after ad.

Peltola is a known quantity in the Last Frontier. She served a full term in 2023 and 2024 and part of another after her surprise special election win in 2022 to replace Republican Don Young after his death following more than 49 years as the state’s at-large representative. She narrowly lost a reelection bid in 2024 to Nick Begich, who’s a Republican unlike his uncle Mark.

She’s also getting some outside help, suggesting Democrats in Washington think she’s got a shot.

Two groups affiliated with the Senate Majority PAC, a Democratic Super PAC, released digital ads last year targeting Sullivan over Medicaid cuts and rising health care prices.

Monica Robinson, a spokeswoman for the Democratic Senatorial Campaign Committee, said health care will be a “top focus in Alaska.”

Peltola has tried to strike a contrast with Sullivan on the issue. She earlier pledged her support for extending the Obamacare subsidies and for reversing the Medicaid cuts.

“If she can distinguish herself from Sen. Sullivan’s position and clearly articulate the detrimental effect Medicaid is going to have, there’s a lot of votes there for her taking,” said former Alaska House Speaker Jim Duncan, a Democrat. “It hits home for her constituents.”

Alaska’s vast geography — with remote communities only reachable by plane, boat or snowmobile — makes health care in the state uniquely inaccessible and more expensive.

“Medicaid was paying for a lot of things like transportation,” said Amber Lee, an Anchorage political consultant who worked for a coalition of health care providers opposing the cuts. “If you're out in the village, and you need emergency care, you're probably going to have to be flown to a hub hospital.”

Alaska House Speaker Bryce Edgmon, an independent, and Senate Majority Leader Cathy Giessel, a Republican, wrote a New York Times op-ed last year that said Alaska “cannot survive” the Medicaid cuts. Jared Kosin, the president of the Alaska Hospital and Healthcare Association, has called the cuts “devastating.”

Democrats are now hoping that Sullivan’s vote for the One Big Beautiful Bill will haunt him.

“That vote will come down to curse Dan Sullivan in his reelection efforts,” said Jim Lottsfeldt, an Alaska lobbyist who said he will wade into the race on behalf of Peltola. “In the cafe meetings and doorstops and meetings at school gymnasiums, health care will dominate other topics.”