Agency Action: Amendment to the Title XIX Medicaid State Plan
Pursuant to 42 CFR §§ 440.386 and 447.205, notice is hereby given that the Department of Health (the department) intends to seek approval from the Centers for Medicare and Medicaid Services (CMS) for amendment to update Medicaid eligibility requirements for certain non-citizens in accordance with Section 71109 of the Working Families Tax Cut Act (WFTCA) of 2025, Public Law 119-21.
Subject of Amendment(s):
The department intends to submit a State Plan Amendment (SPA) to update Alaska Medicaid's non-citizen eligibility provisions to comply with federal requirements established under Section 71109 of the WFTCA.
Beginning October 1, 2026, Section 71109 limits the availability of federal Medicaid matching funds for individuals who are not U.S. citizens or nationals to individuals who meet one of the immigration categories specified in the law. These categories include Lawful Permanent Residents, Cuban and Haitian entrants, and individuals lawfully residing in the United States in accordance with the Compacts of Free Association.
The SPA will revise Alaska's Medicaid eligibility provisions to reflect these federal requirements and remove coverage categories that will no longer qualify for federal Medicaid funding under Section 71109. The amendment will also update the state plan's provisions concerning non-citizen eligibility to align with the revised federal requirements.
The changes will not affect Medicaid coverage for U.S. citizens or nationals or for non-citizens who remain eligible for federally funded Medicaid under the categories specified in Section 71109. Coverage for emergency medical conditions will continue to be provided in accordance with applicable federal requirements.
Financial impact:
The department anticipates that this SPA will result in a reduction in Medicaid expenditures associated with individuals who will no longer qualify for federally funded Medicaid because of the changes required by Section 71109 of the WFTCA.
EPSDT and ARRA/Tribal Consultation:
The proposed amendments will not affect how Alaska Medicaid provides or reimburses EPSDT services. The department followed the tribal consultation process established under the American Recovery and Reinvestment Act (ARRA) of 2009 and set forth in its approved state plan.
Public Comments:
The department is holding a public comment period relative to these amendments until 5 PM on October 1, 2026. Individuals may submit written comments via email to christal.hays@alaska.gov. Please submit electronic comments as an attached word document or text within the email body with the phrase “Non-Citizen SPA Public Comment” in the subject line. All submissions must include the sender’s full name and email address.
If you are a person with a disability who requires a special accommodation to participate in this process, please contact Christal Hays at christal.hays@alaska.gov or (907) 891-4830 not later than September 15th, 2026, to ensure the provision of any necessary accommodations.
Individuals unable to submit comments by email should submit written comments by the close of the comment period to:
DOH Commissioner’s Office
c/o Christal Hays
3601 C Street, Suite 902
Anchorage, AK 99503