2026 Alaska Legislative Session Recap
Alaska’s 2026 regular legislative session ran from January 20 to May 20. The session was primarily shaped by increased revenue projections, education funding, gasline enabling legislation, and addressing rural energy cost increases. For healthcare, the most immediate outcomes included increased Medicaid funding, a major federal investment in rural health, and physician assistant scope-of-practice legislation aimed at expanding access to care in underserved communities. A special session commenced on May 21 on the issue of gasline property tax legislation, it will end on June 20.
HCA Healthcare is providing this end of session recap to keep colleagues informed on key legislative developments that may affect care and access in the communities we serve.
Budget
The Legislature closed session by passing a balanced state operating budget, HB 263, on the final day, allocating more than $8 billion in state funds and $4.5 billion in federal expenditures, totaling to $12.8 billion. The plan funds agency operations and state services, which includes a $1,000 Permanent Fund dividend and $200 energy relief payment, and is paired with a capital budget that sends more than $350 million in state funds to infrastructure and maintenance projects.
For healthcare, one of the most significant budget actions came through the supplemental budget, HB 289, which included $395.5 million for Medicaid Services. The investment in Medicaid includes provider rate increases to help offset inflationary costs. The bill also allows up to $10 million in unspent Medicaid funds to be used for behavioral health clinic services in FY 2026 and FY 2027, providing the Department of Health with additional flexibility to support behavioral health.
Alaska’s improved revenue outlook for FY 2026 and FY 2027 gave lawmakers more room to balance the FY 2027 budget, but healthcare funding is likely to continue to compete with other budget priorities, such as education, energy relief, and infrastructure, in future sessions.
Rural Health Transformation Program
Alaska received about $272.2 million in first-year federal funding from the Rural Health Transformation Program (RHTP). HB 289 appropriated these funds to the Department of Health for FY 2026 through FY 2028 to support rural access, workforce, technology, and care delivery.
The Legislature also passed HJR 32 in support of the program, noting that Alaska received the second-highest total funding allocation and the highest per-capita funding of any state. HJR 32 also urges continued focus on federal guidance, stakeholder engagement, infrastructure flexibility, and workforce development, confirming rural health as an ongoing legislative priority.
The Department of Health received nearly 1,800 Letters of Interest (LOIs) during the submission period. The state has since released initial LOI outcomes showing which proposals will advance to the implementation application stage or planning consideration. 400 applications were moved to the next stage of evaluation, with the department indicating roughly half these applications will receive partial or full funding awards.
HCA Healthcare submitted a Letter of Interest during this initial round. While our proposal was not among those advanced to the implementation application stage, we intend to resubmit when the next round opens.
Workforce and Access
SB 89 would update Alaska’s physician assistant (PA) statutes by defining PA scope of practice, revising rules on collaborative agreement requirements, updating licensure provisions, and limiting insurer contract requirements. The most significant change would allow physician assistants to practice without a collaborative agreement when practicing in certain settings, including physician-directed facilities, federal or tribal facilities, Federally Qualified Health Centers (FQHCs), rural clinics, and military or veterans’ facilities. This flexibility intends to help create more access points in communities facing physician shortages.
SB 89 passed the Legislature and was transmitted to the governor on June 1.
