¶ Overview
- Begich enthusiastically voted for a bill that would kick 17 million Americans off their health insurance, including nearly 12 million Americans off of Medicaid. More than 37,000 Alaskans could lose their health coverage as a result of his votes.
- Begich was previously president of the board of directors at an organization that recommended reconsidering Medicaid expansion, which provided more than 60,000 Alaskans with healthcare.
- Begich was a fellow at an organization that advocated for repealing the Affordable Care Act even though more than 28,000 Alaskans rely on the law for health insurance. Alaskans have the 2nd highest average monthly premiums across America and by voting against renewing enhanced ACA premium tax credits, one Alaskan small business owner said she felt that Begich was “punishing us” with high healthcare costs.
¶ Begich Voted To Kick More Than 37,000 Of His Constituents Off Their Health Insurance And Nearly 12 Million Americans Off Medicaid
¶ Begich Voted to take health coverage from Alaskans
¶ July 2025: Begich Voted For The Final Version Of Republicans’ Reconciliation Bill
7/3/25: Begich Voted For The Senate FY 2025 Budget Reconciliation Bill That Cut Medicaid And Other Social Programs To Offset The Bill’s Costs. In July 2025, Begich voted for, according to Congressional Quarterly, the “motion to concur in the Senate amendment to the bill that would permanently extend nearly $4 trillion in expiring individual and business tax cuts, create several new tax breaks and fund border and immigration enforcement and air traffic control upgrades. It would cut Medicaid and other safety net programs to partly offset the cost. Among other provisions, it would raise the statutory debt ceiling by $5 trillion and appropriate more than $448 billion in mandatory funding for Trump administration priorities and other needs, including $153 billion for defense, $89 billion for immigration enforcement, and $89.5 billion for border control and security. It also would increase the state and local tax deduction cap to $40,000 annually for five years for households making up to $500,000 a year until 2030, when it would permanently revert to $10,000.” The House passed the bill by a vote of 218 to 214. [House Vote 190, 7/3/25; Congressional Quarterly, 7/3/25; Congressional Actions, H.R. 1]
- HEADLINE: "At Least 17 Million Americans Would Lose Insurance Under Trump Plan" [Washington Post, 7/1/25]
- The Congressional Budget Office Estimated That 11.8 Million People Would Become Uninsured As A Result Of The Medicaid Cuts In Republicans’ Reconciliation Bill. According to the Washington Post, "The bill, which narrowly passed the Senate on Tuesday and now heads back to the House, would effectively accomplish what Republicans have long failed to do: unwind many of the key components of the ACA, President Barack Obama’s signature domestic achievement, which dramatically increased the number of Americans with access to health insurance. To start, the Congressional Budget Office estimated that the Senate version of the bill would result in 11.8 million more uninsured in 2034, mostly because of Medicaid cuts, compared with 10.9 million if the House version became law." [Washington Post, 7/1/25]
¶ May 2025: Begich Voted For House Republicans’ Budget Bill, Which Would Kick Millions Of People Off Medicaid
5/22/25: Begich Voted For The FY 2025 Budget Reconciliation Bill That Included $3.8 Trillion In Tax Cuts Offset By $1.5 Trillion In Spending Reductions To Programs Like Medicaid And The Supplemental Nutrition Assistance Program. In May 2025, Begich voted for, according to Congressional Quarterly, “the bill that would provide for approximately $3.8 trillion in net tax cuts and $321 billion in military, border enforcement and judiciary spending, offset by $1.5 trillion in spending reductions, as instructed in the fiscal 2025 budget resolution (H Con Res 14). It would raise the statutory debt limit by $4 trillion and provide for increased spending on defense and border security, spending cuts on social safety net programs, such as Medicaid and the Supplemental Nutrition Assistance Program. It also includes a mix of tax breaks for businesses and individuals; tax increases on universities and foundations; and a phase-down of clean energy tax credits. […] It would reduce federal spending on the Supplemental Nutrition Assistance Program by requiring states to shoulder more of the cost, expand work requirements for SNAP, extend programs authorized under the 2018 farm bill, and prohibit the U.S. Department of Agriculture from increasing the cost of the Thrifty Food Program. As amended, it would cap state and local tax deductions at $40,000 for households with incomes below $500,000.” The House passed the bill by a vote of 215 to 214. [House Vote 145, 5/22/25; Congressional Quarterly, 5/22/25; Congressional Actions, H.R. 1]
- The House GOP Budget Bill Was Estimated To Increase The Uninsured Population By 8.6 Million By 2034. According to CNN, “The Medicaid and Affordable Care Act provisions in the package could result in 8.6 million more people being uninsured in 2034, according to an early CBO estimate released by Democratic lawmakers. That number is expected to grow with the latest changes.” [CNN, 5/28/25]
- The House GOP Budget Bill Codified A Trump Administration Proposal That Restricted Access To The Affordable Care Act. According to CNN, “The bill also calls for codifying a Trump administration proposal that would make changes to the Affordable Care Act enrollment process, including shortening the open enrollment period and eliminating the ability of low-income Americans to sign up year-round.” [CNN, 5/28/25]
¶ February 2025: Begich Voted For A Budget Resolution That Spelled Out Future Medicaid Cuts
2/25/25: Begich Voted For The FY 2025 Budget Framework That Included $2 Trillion In Cuts, Raised The Statutory Debt Limit By $4 Trillion, And Required House Committees To Recommend Legislation That Would Implement Trump’s Agenda. In February 2025, Begich voted for, according to Congressional Quarterly, “the concurrent resolution that would recommend a budget for fiscal 2025 and budget levels through fiscal 2034. The resolution would assume minimum savings of $1.5 trillion over 10 years and 2.6 percent economic growth over the same period. It also would require the statutory debt limit to be raised by $4 trillion. It also would authorize the House Ways and Means Committee to increase deficits by $4.5 trillion over 10 years to extend the 2017 tax cuts and implement new tax cuts proposed by the White House. It also would provide instructions for the budget reconciliation process through which separate legislation could be considered and passed in the Senate via a simple majority vote. The measure would deliver instructions to 11 House committees to report legislation that would implement President Donald Trump’s agenda, such as expanding tax cuts and bolstering border security and immigration enforcement. The committees would be required to report their legislative recommendations to the House Budget Committee by March 27, 2025. It also would set a $2 trillion target for the spending cuts to be submitted to the House Budget Committee. The resolution also would stipulate that if the committees don't reach that target, the Ways and Means’ reconciliation instructions to increase the deficit by a maximum of $4.5 trillion would be decreased by the amount the other committees come in below the target. Similarly, it would stipulate that Ways and Means could increase the deficit above the $4.5 trillion level by the amount of savings the committees achieve above the $2 trillion target.” The vote was on passage. The House passed the resolution by a vote of 217 to 215. [House Vote 50, 2/25/25; Congressional Quarterly, 2/25/25; Congressional Actions, H. Con. Res. 14]
- HEADLINE: “What Can House Republicans Cut Instead Of Medicaid? Not Much.” [New York Times, 2/25/25]
- HEADLINE: "House Republican Budget Takes Away Health Care, Food Aid To Pay For Expanded Tax Cuts For Wealthy" [Center on Budget and Policy Priorities, 2/21/25]
- New York Times Reported The $880 Billion In Cuts Required By The Republican Budget Proposal Would Have To Come From Medicaid, Medicare, Or CHIP. According to the New York Times, "The budget resolution itself is silent on whether Congress cuts Medicaid, which provides health coverage to 72 million poor and disabled Americans. But it instructs the House Energy and Commerce Committee, which has jurisdiction over the program, to cut spending by $880 billion over the next decade. If the committee can’t save at least that much, the entire effort could be imperiled because of the special process Congress is using to avoid a Senate filibuster. Ten other committees have their own instructions to follow, though none have been assigned with cutting nearly as much. It’s not so simple as finding the cuts elsewhere. The special process, known as budget reconciliation, means Republicans will have to find all $880 billion from within the Energy and Commerce Committee’s jurisdiction. That leaves them with fewer options than one might think. […] If Republicans want to avoid major cuts to Medicaid, the largest pot of available money is in the other big government health insurance program: Medicare. […] Even if the committee cuts everything that’s not health care to $0, it will still be more than $600 billion short. The committee could also save around $200 billion by eliminating the Children’s Health Insurance Program, but that option has not been raised by the budget committee or anyone in House leadership. […] Even if all of these cuts, revenues and rule cancellations from outside health care can pass muster, the committee will still be left with hundreds of billions of dollars to cut to hit its goal. Mathematically, the budget committee’s instructions mean the committee would need to make major cuts to either Medicare, Medicaid or both." [New York Times, 2/25/25]
¶ begich CLAIMED THE “BIG BEAUTIFUL BILL” PROTECTED “VULNERABLE” medicaid enrollees
Begich Told Constituents That The Big Beautiful Bill Included “Protections For Those On Medicaid To Ensure The Program Remains Strong For The Vulnerable.” According to Rep. Nick Begich’s Facebook, “We just opened 30 MILLION acres of Alaska for oil and gas exploration in - the 1002 Area - the National Petroleum Reserve - the Cook Inlet This is an area roughly the size of the state of Florida! We also have landed the HIGHEST revenue share of federal royalties for Alaska since the pipeline was approved. This keeps the Permanent Fund strong and supports higher dividends well into the future. That’s EXTRAORDINARY, but it doesn’t stop there. No tax on tips. No tax on overtime. The largest tax break in American history for our nation’s seniors. Billions to secure our borders and stem the tide of fentanyl entering our country. The largest investment in Coast Guard infrastructure in history including 16 ice breakers. Protections for those on Medicaid to ensure the program remains strong for the vulnerable. Unlocking Alaska’s renewable timber resources, allowing the industry to create Alaskan jobs again. Many said Alaska’s future would be about dependency. Now, our future will be defined by prosperity. Alaska sent me here to get this done. North to the Future!” [Facebook, Nick Begich, 7/3/25]
¶ Begich Was “honored” to vote for the “big beautiful bill” and “enthusiastically” supported IT
Begich Said “He’s Been A Strong Supporter Of The Budget Bill Since Even Before It Was Proposed” And That “There Was No Doubt I Was Going To Vote For This Bill.” According to the Alaska Beacon, "Alaska’s lone member of the U.S. House of Representatives said Thursday that he had ‘no doubt’ that he was going to vote for the Republican-drafted budget bill that passed the House on a 218-214 vote Thursday. […] Begich said he’s been a strong supporter of the budget bill since even before it was proposed at the start of the new Congress. ‘There was no doubt I was going to vote for this bill,’ he said. ‘I started working on this bill before I was even sworn into Congress. I approached leadership when it looked like we were going to win this seat. And I told them, budget reconciliation is around the corner.’ Begich said that House leaders tried to reassure him that ANWR drilling provisions would be in the bill, but he advocated more drilling, in NPR-A and Cook Inlet, and additional provisions to support mining and logging. ‘So when this bill came back from the Senate, I was enthusiastically supporting it, and I told others in the House that this is an important priority for us, certainly, but it’s really important for the rest of the nation,’ Begich said."[Alaska Beacon, 7/4/25]
When The Budget Bill Came Back From The Senate, Begich Said He Was “Enthusiastically Supporting It.”According to the Alaska Beacon, "Alaska’s lone member of the U.S. House of Representatives said Thursday that he had ‘no doubt’ that he was going to vote for the Republican-drafted budget bill that passed the House on a 218-214 vote Thursday. […] Begich said he’s been a strong supporter of the budget bill since even before it was proposed at the start of the new Congress. ‘There was no doubt I was going to vote for this bill,’ he said. ‘I started working on this bill before I was even sworn into Congress. I approached leadership when it looked like we were going to win this seat. And I told them, budget reconciliation is around the corner.’ Begich said that House leaders tried to reassure him that ANWR drilling provisions would be in the bill, but he advocated more drilling, in NPR-A and Cook Inlet, and additional provisions to support mining and logging. ‘So when this bill came back from the Senate, I was enthusiastically supporting it, and I told others in the House that this is an important priority for us, certainly, but it’s really important for the rest of the nation,’ Begich said."[Alaska Beacon, 7/4/25]
Begich Said He Was “Honored” To Deliver The Big Beautiful Bill To Trump’s Desk For It To Become Law. According to Rep. Nick Begich’s Twitter, "Today, the Republican-led Congress sent the One Big Beautiful Bill Act to the President’s desk, and with it a blueprint for Alaska’s self-determined future. I am honored to serve and deliver for the state we love: ☑️Unlocking our resources. Mandatory lease sales open 1.6 million acres in ANWR, 20 million acres in the NPR-A, and 6 million acres in Cook Inlet - more than 30 million acres in total, almost the size of the entire state of Florida! Alaska will receive a greater share of federal royalties than ever before, growing the Permanent Fund and keeping PFDs strong for decades. ☑️Putting money back in your pocket. Overtime and tips are now tax-free, small-business depreciation is immediate, and the Trump tax cuts are made permanent so families can save, and businesses can hire. Further, there are even additional deductions for seniors on Social Security. ☑️Securing the border. More than $100 billion in new resources equips Border Patrol agents and delivers advanced technology to help stop fentanyl before it reaches Alaska’s towns and villages. ☑️Investing in safety. The single largest Coast Guard appropriation in U.S. history funds 16 new Arctic-class icebreakers and major port upgrades, while $12.5 billion modernizes Air Traffic Control. This bill protects mariners, pilots, and every community that depends on them. ☑️Protecting care where it is needed. Medicaid integrity reforms guarantee help for the truly vulnerable, and new rural-hospital funding helps keep all Alaskans healthy. This legislation fulfills our longstanding goal: Alaska charting its own course, creating good-paying jobs today, and providing opportunity for generations to come. North to the Future!" [Twitter, @RepNickBegich, 7/3/25]
Begich Said The Big Beautiful Bill Was A “Transformative Victory” For Alaska. According to a press release from Rep. Nick Begich, "Today, Congressman Nick Begich released the following statement after the final passage of the One Big Beautiful Bill Act: Today, Congress finalized one of the most consequential legislative efforts in decades by passing the One Big Beautiful Bill Act. For Alaska, this is a transformative victory. This bill solidifies Alaska’s position as a cornerstone of our nation’s energy future, mandating lease sales of at least 1.6 million acres in ANWR, 20 million acres in NPR-A, and at least 6 million acres in Cook Inlet, growing Alaska’s royalties on these lands by 40 percent getting us one step closer to fulfilling the promise guaranteed to us at Statehood. These leases will unlock tens of billions in investment, generate thousands of high-paying jobs, and restore Alaska’s right to produce. This bill also codifies a 25% increase in timber harvests on federal lands, providing our long sought pathway for Alaska’s forest economy." [Press Release – Rep. Nick Begich, 7/3/25]
¶ More Than 37,000 Alaskans Could Lose Health Coverage A Result Of Begich’s Votes
An Estimated 37,101 People In Begich’s District On The Affordable Care Act And Medicaid Could Lose Coverage Due To Republican Budget Bill Health Care Cuts. According to the Joint Economic Committee, an estimated 37,101 people in the AK-AL district could lose ACA and Medicaid coverage as a result of Republican cuts. [Joint Economic Committee, Viewed 5/8/26]
2023: 164,700 Alaskans Were Enrolled In Medicaid Or CHIP. According to the Center for American Progress,
[Center for American Progress, 3/11/25]
Cuts To Medicaid Would Specifically Impact Alaska Native People, Who Made Up 40% Of All Medicaid Enrollees In Alaska. According to a press release from Families USA, "A new fact sheet details the impacts of deep cuts to the Medicaid program in the Republican budget proposal that Rep. Nick Begich voted for, which would have devastating consequences for the health and economic security of Alaska. Medicaid provides health care coverage for nearly 100,000 Alaska native people, including 83,200 children, according to a new fact sheet from Families USA. ‘Americans have been showing up in townhalls, calling their representatives in Congress and demanding that Republicans in Washington stop their plan to massively cut the health care that Americans want and need,’ said Anthony Wright, executive director of Families USA. ‘The proposed deep cuts to Medicaid would be devastating for Alaska residents, resulting in significant coverage losses, forcing rural hospitals, long-term care facilities or community clinics to close or scale back services, and throwing state budgets into crisis. We should all be asking every member of Congress who voted for this budget why they are willing to harm working families in their own district just to pay for a tax break for billionaires.’ Medicaid is a lifeline for Alaska: Nearly 100,000 native people — 40% of all Medicaid enrollees in Alaska. 83,200 children are on Medicaid — 48% of all children in Alaska. 27,700 seniors and people with disabilities have Medicaid coverage." [Press Release - Families USA, 3/19/25]
¶ Begich Worked At Organizations That Advocated For Repealing The Affordable Care Act And Opposed Medicaid Expansion
¶ 2018-2021: Begich Was President Of Board Of Directors At The Alaska Policy Forum, Which Opposed Medicaid Expansion
2018-2021: Begich Served As The Board President Of The Board Of Directors At The Alaska Policy Forum. According to Begich’s Linkedin, Begich served as board president on the board of directors for Alaska Policy Forum from November 2018 through October 2021. [LinkedIn, Nicholas Begich III, Viewed 5/15/26]
2020: The Alaska Policy Forum Published An Article That Recommended “Reconsidering Medicaid Expansion.”. According to Alaska Policy Forum, “The combined impact of high Medicaid enrollment rates, year after year, with far above average Medicaid reimbursement rates, is certainly contributing to Alaska’s highest-in-the-nation health care spending, and could also be significantly affecting the high price of health care services. If Alaskans want to see themselves and their government spend less on health care, reconsidering Medicaid expansion and renegotiating reimbursement rates with the federal government are the first steps.” [Alaska Policy Forum, 9/21/20]
- As Of April 2026, Over 60,000 Alaskans Were Covered By Medicaid Expansion. According to the Alaska Department Of Health,
[Alaska Department Of Health, 4/26]
¶ Begich Served AS A FELLOW at an organization that advocated for repealing the AFFORDABLE CARE ACT
¶ Begich Served As A Fellow At Club For Growth Which Supported Repealing The Affordable Care Act
Since 2020, Begich Has Served As A Fellow At The Club For Growth. According to Begich’s LinkedIn, Begich became a fellow at Club for Growth in June 2020.
[LinkedIn, Nicholas Begich III, Viewed 5/15/26]
Club For Growth Advocated For Repealing The Affordable Care Act. According to Club For Growth’s website, “Entitlements: Entitlement programs are the single largest drivers of our nation’s mounting debt and must be reformed immediately before it’s too late. Not only is our current entitlement system bankrupting our nation, it is simply unsustainable in its current form. Policy Recommendations: Repeal Obamacare. Enact Medicare reform that utilizes a premium-support function to replace the current system. Block-grant Medicaid to the states. Create Social Security personal retirement accounts that workers would own and could use to build nest eggs for retirement.” [Club For Growth, Viewed 5/15/26]
Club For Growth Advocated For Block-Granting Medicaid To The States. According to Club For Growth’s website, “Entitlements: Entitlement programs are the single largest drivers of our nation’s mounting debt and must be reformed immediately before it’s too late. Not only is our current entitlement system bankrupting our nation, it is simply unsustainable in its current form. Policy Recommendations: Repeal Obamacare. Enact Medicare reform that utilizes a premium-support function to replace the current system. Block-grant Medicaid to the states. Create Social Security personal retirement accounts that workers would own and could use to build nest eggs for retirement.” [Club For Growth, Viewed 5/15/26]
- Block Grants For Medicaid Would Give States A “Fixed Amount” Of Funding For All Of The Medicaid Program And Some Block Grant Proposals “Would Cap The Amount Of Federal Funding States Get On A Per Person Basis.” According to KFF, "When former president Donald Trump said he would not cut Social Security or Medicare if elected, his silence on Medicaid raised eyebrows in the health policy world. Afterall, Medicaid is our largest public health insurance program covering about 85 million Americans. It is also the single largest source of federal funding for states. His comment conjured up images of a return to the wars over a Medicaid block grant or a variation on it called a per capita cap. Both give states greater flexibility over eligibility and benefits in Medicaid in return for big cuts over time in federal Medicaid spending. It’s an idea that first surfaced with Ronald Reagan and has reappeared several times since. Now it’s one of the proposals included in plans put together by the Republican Study Committee in the House, and it’s likely to resurface if Trump and the Republicans emerge with control of the government in November. It’s such a significant policy change affecting so many people and every state that it’s worth revisiting the essentials of the idea as well as its politics and prospects. There have been numerous block grant and per capita cap proposals over the years. Some would give states a fixed amount or ‘block grant’ for all of the Medicaid program and some for parts of it. Some would cap the amount of federal funding states get on a per person basis, allowing funding to grow with enrollment. More recent plans combined the idea with Affordable Care Act (ACA) repeal. For example, the Graham-Cassidy proposal, which emerged in the 2017 ACA repeal debate, combined a block grant for ACA subsidies and ACA Medicaid expansion with a cap in the traditional Medicaid program. All would set funding levels well below what the federal government is expected to spend under the current program to produce significant federal budget savings. Most would phase in the changes to cushion the impact. All would give states substantially greater flexibility to operate their programs." [KFF, 3/26/24]
- One Proposed Block Grant Plan “Would Have Reduced Federal Medicaid Funding By More Than 25% Over 10 Years” Resulting In Coverage For Fewer People And Benefits Being Cut. According to KFF, "How big would the cuts be? They can be any size but as an example, the Congressional Budget Office (CBO) projected that one of the Medicaid block grant plans put forward as part of the Republican Repeal and Replace debate in 2017 would have reduced federal Medicaid funding by more than 25% over 10 years and 30% over 20 years. Medicaid is already a low-end payer for many services in many states, and less money for states can only mean three things: Covering fewer people, cutting benefits, and the time-honored favorite, lowering payment rates for providers. There is no magic delivery reform that is an alternative to these outcomes. Of course, states could also reduce spending on other budget lines items to keep Medicaid whole, such as education and corrections, or raise taxes, although these are hardly palatable options. They could also shrink their Medicaid programs, leaving more people reliant on safety net hospitals and clinics and without insurance." [KFF, 3/26/24]
¶ Begich Allowed Critical Health Care Tax Credits That Alaskans Rely On To Expire
¶ begich Voted against extending ENHANCED ACA premium tax credits and allowed them to expire
¶ Begich Voted Three Times Against Extending Enhanced ACA Premium Tax Credits For Three Years
1/8/26: Begich Voted Against Extending The Affordable Care Act Tax Credits For Three Years. In January 2026, Begich voted against, according to Congressional Quarterly, “the bill, as amended, that would extend for three years, through the end of calendar year 2028, the enhanced tax credits to subsidize premiums for health insurance purchased on the Affordable Health Care Act health insurance markets. It would allow taxpayers whose household income exceeds 400 percent of the federal poverty line to receive tax credits for three more years. The measure would retroactively take effect Jan. 1, 2026.” The vote was on passage. The House passed the bill by a vote of 230 to 196. [House Vote 11, 1/8/26; Congressional Quarterly, 1/8/26; Congressional Actions. H.R. 1834]
- 17 Republicans Voted For Passage Of The “Clean” Extension, Following A Procedural Vote The Day Before That Had Support From Nine Republicans. According to Politico, “Seventeen Republicans joined Democrats in passing legislation Thursday that would revive enhanced Affordable Care Act subsidies for three years, rebuffing opposition from GOP leadership. The 230-196 vote follows a procedural vote Wednesday to advance the bill, where nine Republicans joined Democrats in favor of moving forward.” [Politico, 1/8/26]
- Speaker Johnson Called The Bill “Really Bad Policy” And Said He Wished That Not Everyone Had A Vote. According to Politico, “Johnson’s office, in a last-ditch effort Thursday morning to undermine the effort, blasted out a memo accusing ‘Democrats [of] want[ing] to expand a COVID subsidy system already flagged for massive fraud and abuse, with absolutely zero reforms.’ After the vote Thursday evening, Johnson said in an interview of the Republicans who defected, ‘I think it’s a really bad policy, and I wish they hadn’t, but everybody had a vote.’” [Politico, 1/8/26]
1/8/26: Begich Effectively Voted Against Extending The Affordable Care Act Tax Credits. In January 2026, Begich voted against, according to Congressional Quarterly, the “adoption of the rule (H Res 780) providing for consideration of the bill (HR 1834). It would consider as adopted the McGovern, D-Mass., substitute amendment that would extend, through 2028, the enhanced tax credits to subsidize premiums for health insurance purchased on the Affordable Health Care Act health insurance markets. The rule would direct the clerk to transmit to the Senate a message that the House has passed HR 1834 no later than one calendar day after passage.” The vote was on the adoption of the rule. The House agreed to the motion by a vote of 224 to 202. [House Vote 10, 1/8/26; Congressional Quarterly, 1/8/26; Congressional Actions, H.Res. 780; Congressional Actions. H.R. 1834]
1/7/26: Begich Effectively Voted Against Extending The Affordable Care Act Tax Credit. In January 2026, Begich voted against, according to Congressional Quarterly, the “motion to discharge from the House Rules Committee the rule (H Res 780) providing for consideration of the anticipated ACA tax credit extension vehicle (HR 1834).” The vote was on the motion to discharge the rule. The House agreed to the motion by a vote of 221 to 205. [House Vote 4, 1/7/26; Congressional Quarterly, 1/7/26; Congressional Actions, H.Res. 780; Congressional Actions. H.R. 1834]
¶ Begich Did Not Sign Discharge Petitions Aimed At Extending Premium ACA Tax Credits
Begich Was Not One Of The Republican Signers On A Discharge Petition Led By House Minority Leader Hakeem Jeffries.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 10, 11/12/25]
- House Minority Leader Jeffries’ Discharge Petition Sought To Extend ACA Premium Tax Credits For Three Years. According to Politico Pulse, "House Democrats could move as soon as tomorrow to force a vote on extending the expired Obamacare subsidies for three years, Meredith Lee Hill reports. This measure follows last month’s major setback for Speaker Mike Johnson, when four House Republicans broke from the party to support a discharge petition backed by Minority Leader Hakeem Jeffries to hold a vote." [Politico Pulse, 1/6/26]
Begich Was Not One Of The Republican Signers On A Discharge Petition Led By Rep. Brian Fitzpatrick.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 12, 12/10/25]
- December 2025: Fitzpatrick Filed A Discharge Petition Aimed At Extending ACA Premium Tax Credits For Two Years. According to a press release from Rep. Brian Fitzpatrick, "Today, Congressman Brian Fitzpatrick (PA-1) released the following statement after filing a discharge petition to bring his Bipartisan Health Insurance Affordability Act directly to the House floor for a vote, ensuring Congress takes action to prevent devastating health insurance premium increases when current protections expire at the end of the year: ‘Congress cannot sit idle while American families face a preventable crisis. Our job is to protect the people we serve, and that responsibility demands immediate action. […] Key Provisions of the Bipartisan Health Insurance Affordability Act The legislation advances five reforms designed to protect affordability, strengthen accountability, and ensure taxpayer value: Prevents premium spikes: Extends enhanced premium tax credits through 2027, to protect families from abrupt monthly cost increases. Restores Consumer Control: Stops unauthorized plan and subsidy changes by requiring consent and prompt notification before any modifications take effect. Shines Light on Middlemen: Ends hidden spread pricing, severs PBM profits from drug prices, and requires full rebate pass-through to ensure savings reach patients. Gives Families New Tools to Manage Costs: Expands access to Health Savings Accounts and simplifies premium payments to reduce disruptions in coverage. Smart Stewardship of Taxpayer Dollars: Modernizes eligibility and introduces a reasonable minimum contribution to protect long-term affordability and responsible stewardship of federal dollars." [Press Release – Rep. Brian Fitzpatrick, 12/10/25]
Begich Was Not One Of The Republican Signers On A Discharge Petition Led By Rep. Josh Gottheimer.
[Clerk of the U.S. House of Representatives, Discharge Petition No. 13, 12/10/25]
- December 2025: Gottheimer Filed A Discharge Petition Aimed At Extending ACA Premium Stax Credits For Two Years. According to a press release from Rep. Josh Gottheimer, "Today, December 11, 2025, U.S. Congressman Josh Gottheimer (NJ-5) released the following statement: ‘In less than three weeks, unless Congress acts now, Affordable Care Act tax credits will expire, and health insurance premiums will shoot up 175% — or $20,000 a year — for families in Jersey. This week, Congresswoman Jen Kiggans and I, with 36 of our Democratic and Republican colleagues, introduced new bipartisan legislation that includes a two-year extension of health insurance premium tax cuts for American families. It’s a commonsense proposal that will keep costs down and prevent families’ premiums from skyrocketing in January. But, the Speaker of the House is refusing to bring our legislation to the floor for a vote. So, our bipartisan group just launched a discharge petition to force an immediate vote in the House. We must get this done now. We must find common ground and lower health insurance premiums. Time is running out for families.’" [Press Release – Rep. Josh Gottheimer, 12/11/25]
¶ Begich’s Failures on healthcare Hurt Alaskans Who RelIED on the enhanced premium tax credits
¶ ACA Enrollment In Alaska Fell By 11% After Begich Allowed The Enhanced Premium Tax Credits To Expire
2026: Enrollment In ACA Marketplace Plans In Alaska Fell By 11% When The Enhanced Premium Tax Credits Were Not Renewed. According to Anchorage Daily News, "The number of Alaskans enrolled in health insurance through the Affordable Care Act dropped by more than 3,000 between 2025 and the first month of the year, according to federal data released this week. The drop comes amid the expiration of enhanced premium tax credits, which were implemented in 2022 to reduce the cost of health insurance purchased on the federal exchange. For many Alaskans who relied on the subsidies, their elimination meant a doubling or tripling in the cost of premiums. Figures published by the federal government on Monday indicated that 25,493 Alaskans had enrolled in Affordable Care Act plans starting Jan. 1, down from 28,736 enrolled in 2025. The numbers represent an 11% decline in enrollment, with further changes expected." [Anchorage Daily News, 1/14/26]
- 2025: More Than 28,000 Alaskans Enrolled in ACA Marketplace Plans. According to the Kaiser Family Foundation, in 2025, 28,736 people in Alaska enrolled in an Affordable Care Act marketplace health insurance plan. [Kaiser Family Foundation, Viewed, 5/8/26]
- In May 2026, The Number Of Alaskans Who Enrolled In ACA Marketplace Plans Had Fallen To 26,079. According to the Kaiser Family Foundation, in 2026, 26,079 people in Alaska enrolled in an Affordable Care Act marketplace health insurance plan. [Kaiser Family Foundation, Viewed, 5/8/26]
¶ Alaskan Small-Business Owners Said They Felt Like Congress Was Punishing Them With Uniquely High Insurance Costs
Alaskan Small-Business Owners Were Among Those Who Would “See The Sharpest Increase In Their Insurance Costs” If The Affordable Care Act Enhanced Tax Credits Were Not Renewed. According to Anchorage Daily News, "Thousands of Alaskans who purchase insurance through the Affordable Care Act marketplace will see their premiums skyrocket without the extension of subsidies that are set to expire at the end of the year. The expiration of the enhanced premium tax credits could cripple small businesses in Alaska, some owners say, as they face premiums that in some cases will triple year over year, eating away at their ability to keep their businesses afloat. […] ‘I need my government, specifically my congressional delegation, to speak for me concerning the levers of power in this country, and I feel absolutely abandoned,’ said Mark Robokoff, who owns a pet supply shop in Anchorage and is staring down a more than 300% increase in the cost of insurance. The impact of the elimination of the tax credits depends on the income, age and family size of the enrollee. Premium increases are greatest for Alaskans nearing retirement age who earn 401% of the poverty line or higher. Of the roughly 25,000 Alaskans enrolled in plans purchased through the Affordable Care Act marketplace, many of those who will see the sharpest increase in insurance costs are owners of small businesses who say their contributions to the Alaska economy are on the line." [Anchorage Daily News, 11/16/25]
One Small-Business Owner Said Rising Health Insurance Costs Made Her Consider Closing Her Business. According to Anchorage Daily News, "Thousands of Alaskans who purchase insurance through the Affordable Care Act marketplace will see their premiums skyrocket without the extension of subsidies that are set to expire at the end of the year. The expiration of the enhanced premium tax credits could cripple small businesses in Alaska, some owners say, as they face premiums that in some cases will triple year over year, eating away at their ability to keep their businesses afloat. ‘We’re working tooth and nail every day to make our way so we don’t have to rely on any help and assistance,’ said Brie Loidolt, who owns a bookkeeping business in Anchorage and is facing an increase of hundreds of dollars per month in her premium costs. Congress is ‘just punishing us for being small-business owners,’ said Loidolt, who has weighed closing her business in response to the rise in health insurance costs." [Anchorage Daily News, 11/16/25]
- The Alaskan Small Business Owner Said She Felt That Congress Was “Just Punishing Us For Being Small-Business Owners” By Not Renewing The Enhanced Premium Tax Credits. According to Anchorage Daily News, "Thousands of Alaskans who purchase insurance through the Affordable Care Act marketplace will see their premiums skyrocket without the extension of subsidies that are set to expire at the end of the year. The expiration of the enhanced premium tax credits could cripple small businesses in Alaska, some owners say, as they face premiums that in some cases will triple year over year, eating away at their ability to keep their businesses afloat. ‘We’re working tooth and nail every day to make our way so we don’t have to rely on any help and assistance,’ said Brie Loidolt, who owns a bookkeeping business in Anchorage and is facing an increase of hundreds of dollars per month in her premium costs. Congress is ‘just punishing us for being small-business owners,’ said Loidolt, who has weighed closing her business in response to the rise in health insurance costs." [Anchorage Daily News, 11/16/25]
A Pet Supply Store Owner Said He Felt “Absolutely Abandoned” By His Congressional Delegation As He Would Face A 300% Increase In Insurance Cost Without The Enhanced Premium Tax Credits. According to Anchorage Daily News, "Thousands of Alaskans who purchase insurance through the Affordable Care Act marketplace will see their premiums skyrocket without the extension of subsidies that are set to expire at the end of the year. The expiration of the enhanced premium tax credits could cripple small businesses in Alaska, some owners say, as they face premiums that in some cases will triple year over year, eating away at their ability to keep their businesses afloat. […] ‘I need my government, specifically my congressional delegation, to speak for me concerning the levers of power in this country, and I feel absolutely abandoned,’ said Mark Robokoff, who owns a pet supply shop in Anchorage and is staring down a more than 300% increase in the cost of insurance. The impact of the elimination of the tax credits depends on the income, age and family size of the enrollee. Premium increases are greatest for Alaskans nearing retirement age who earn 401% of the poverty line or higher. Of the roughly 25,000 Alaskans enrolled in plans purchased through the Affordable Care Act marketplace, many of those who will see the sharpest increase in insurance costs are owners of small businesses who say their contributions to the Alaska economy are on the line." [Anchorage Daily News, 11/16/25]
An Accounting Firm Owner Said She Already Paid $1,347 A Month In Premiums And Without The Extension Of Premium Tax Credits, She Would Be Forced Pay An Additional $500 A Month. "Thousands of Alaskans who purchase insurance through the Affordable Care Act marketplace will see their premiums skyrocket without the extension of subsidies that are set to expire at the end of the year. The expiration of the enhanced premium tax credits could cripple small businesses in Alaska, some owners say, as they face premiums that in some cases will triple year over year, eating away at their ability to keep their businesses afloat. […] Loidolt, who owns an accounting firm that employs four people, said her insurance premiums are set to go up roughly $500 per month, or $6,000 for the year, without the subsidies. She already pays $1,347 per month in premiums. Without the extension of the subsidies, she’ll be paying more per month for her health insurance than she spends on her mortgage." [Anchorage Daily News, 11/16/25]
¶ Begich’s Inaction On Enhanced Premium Tax Credits Created A Dramatic “Subsidy Cliff”
The Expiration Of Enhanced ACA Premium Tax Credits Created A “Subsidy Cliff” Whereby If Households Earned Even $1 More Than A Specific Income Threshold They Could Lose All Eligibility For Assistance. According to CNBC, "For the first time in years, many Americans enrolled in a health insurance plan via the Affordable Care Act marketplace will need to keep a careful accounting of their annual income — or risk a hefty federal tax bill. Enhanced ACA subsidies lapsed at the end of 2025, leaving millions of households on the hook for higher insurance premiums. The lapse also reintroduced the so-called subsidy cliff, whereby households that earn even $1 more than a specific income threshold will lose all eligibility for subsidies, also known as premium tax credits. That income cutoff, which varies by family size, is $62,600 for a single person, $84,600 for a two-person household and $128,600 for a family of four in 2026, for example." [CNBC, 1/6/26]
- More Than Two Million Americans Had Incomes Near A “Subsidy Cliff.” According to CNBC, "More than 2 million people enrolled in an ACA marketplace plan have an income near the subsidy cliff. ACA enrollees also tend to have relatively volatile incomes, making it hard to predict their annual earnings, experts said." [CNBC, 1/6/26]
Households That Went Over The Income Limit Would Have To Pay Back Any Federal Assistance They Received For Premiums, Which Could Cost Thousands Of Dollars, When They Filed Their Taxes. According to CNBC, "Households over the limit would have to pay back any federal subsidies they received for premiums — potentially worth thousands of dollars — when they file taxes next year for 2026." [CNBC, 1/6/26]
Republicans’ Big Beautiful Bill Exacerbated The Problem By Stripping Away Guardrails Capping The Amount Of Excess Subsidies Households Are Required To Repay. According to CNBC, "The potential financial impact is exacerbated by a multitrillion-dollar legislative package known as the ‘big beautiful bill’ that Republicans passed over the summer, which stripped away guardrails capping the amount of excess subsidies households must repay, experts said." [CNBC, 1/6/26]
¶ 22 Million Americans Relied On ACA Premium Tax Credits To Afford Health Insurance
Approximately 22 Million Americans Relied On ACA Premium Tax Credits To Afford Health Insurance. According to CNBC, "About 22 million Americans received premium subsidies, also known as premium tax credits, in 2025. Households can opt to receive the tax credit in one of two ways: As a lump sum during tax season or as an advanced payment. Under the latter option, by far the most popular, the federal government issues the tax credit directly to a consumer’s insurer, which then lowers the consumer’s out-of-pocket premium. Consumers receive those advanced ACA subsidies based on an estimated annual income they provide when signing up for insurance. They must reconcile those subsidies during tax season and repay any excess tax credits to the IRS." [CNBC, 1/6/26]
¶ Begich voted for a bill that would weaken protections for people with pre-existing conditions and failed to address premium spikes CAUSED BY THE LAPSE IN PREMIUM TAX CREDIT EXTENSION
¶ December 2025: Begich Voted For The Lower Health Care Premiums For All Americans Act
2025: Begich Voted For The Lower Health Care Premiums For All Americans Act That Allowed The ACA Tax Credits To Expire. In December 2025, Begich voted for, according to Congressional Quarterly, “the bill that would expand the ability of small businesses to establish association health plans and bars states from preventing small businesses from obtaining stop-loss insurance for self-funded health insurance plans. It would codify and expand rules governing employer-funded health reimbursement arrangements and would allow employees in such arrangements to pay Affordable Care Act health insurance premiums through salary reductions. It would provide funding for ACA policy cost sharing reduction payments that reduce deductibles and copayments. It would prohibit plans from providing abortion-related care. It also would require pharmacy benefit managers to provide transparency regarding prescription drug costs and the drug rebates they receive.” The vote was on passage. The House passed the bill by a vote of 216 to 211. [House Vote 349, 12/17/25; Congressional Quarterly, 12/17/25; Congressional Actions, H.R. 6703]
¶ The Lower Health Care Premiums For All Americans Act Did Nothing To Address The Expiration Of ACA Enhanced Premium Tax Credits And Would Weaken Protections For People With Pre-Existing Conditions
The December 2025 Republican Health Care Bill Failed To Prevent Imminent Premium Spikes For More Than 20 Million People Who Relied On ACA Marketplace Plans. According to the Center on Budget and Policy Priorities, "The health bill House Republicans are preparing to bring to the floor this week not only fails to prevent imminent premium spikes for more than 20 million people in marketplace plans, but would raise costs even higher for many marketplace enrollees and weaken pre-existing condition protections for individuals and small businesses." [Center on Budget and Policy Priorities, 12/16/25]
- HEADLINE: "House Republicans Pass Health Care Plan Without Re-Upping Insurance Subsidies" [Politico, 12/17/25]
- HEADLINE: "House Passes GOP Health Bill Without Subsidies" [Axios, 12/17/25]
- HEADLINE: "House Passes GOP Health Care Bill Without Obamacare Subsidy Extension" [The Hill, 12/17/25]
- HEADLINE: "House Passes GOP Health Care Bill Without ACA Extension" [CBS News, 12/17/25]
The December 2025 Republican Health Care Bill Would Expand Association Health Plans, Which Would Result In Higher Underlying Premiums For Individuals And Small Businesses That Remained In ACA-Regulated Markets. According to the Center on Budget and Policy Priorities, "It would expand association health plans (AHPs), a type of health plan that trade associations, professional groups, and other organizations may offer their members, to cover self-employed individuals and small businesses as if they were large employers. By allowing more people to enroll in coverage not subject to ACA standards and consumer protections, this would segment insurance risk pools: individuals who are younger and healthier, or small businesses with younger or healthier employees, could get plans with lower premiums because they would be priced separately from ACA-compliant coverage and wouldn’t have to meet ACA standards such as having to cover a set of essential health benefits. As a result, individuals and small businesses remaining in ACA-regulated markets would see higher underlying premiums." [Center on Budget and Policy Priorities, 12/16/25]
The December 2025 Republican Health Care Bill Would Likely Lead To Higher Premiums For Older And Sicker Small Groups And Self-Employed People, Thereby Undermining Protections For People With Pre-Existing Conditions. According to the Center on Budget and Policy Priorities, "In addition, the bill would undermine protections for people with pre-existing conditions. While it would bar AHPs from rejecting individuals or charging them more based on certain health factors, it would give them greater ability to base a small group’s or self-employed person’s costs on their health risk compared to individual or small-group coverage. This would likely lead to higher premiums for older and sicker small groups and self-employed individuals, making such arrangements more attractive to healthier individuals and groups." [Center on Budget and Policy Priorities, 12/16/25]