Alaska expanded Medicaid, so the federal work requirement that takes effect January 1, 2027 applies to its expansion adults. About 61,244 of them (13.7% of an expansion pool of 65,471) will have to prove 80 hours a month of work, school, or service, or an exemption, to keep coverage.
This model's bottom-up estimate is that 35,542 people in Alaska lose coverage by 2034: 33,704 of them still eligible but lost to paperwork and reporting failures, and 1,837 not meeting the requirement. Nationally the same model gives 5,461,400, against CBO's 5,200,000.
Whether those eligible people keep coverage depends on the state's ability to renew them automatically (ex parte) from data it already holds. Alaska scores 57 of 100 on this model's ex parte capability index, a mid band; its eligibility system is ARIES (planned migration).
Key figures
| Measure | Alaska |
|---|---|
| Expansion state | Yes |
| Subject to the requirement via waiver | No |
| Expansion pool (adults 19 to 64) | 65,471 |
| Adults subject, strict definition | 61,244 |
| Adults subject, permissive definition | 60,019 |
| Share of expansion pool subject | 13.7% |
| Projected coverage loss by 2034 | 35,542 |
| Hardship exception status | Undecided |
| Early implementer | No |
| Ex parte capability score (0 to 100) | 57 (mid) |
Who is subject in Alaska
Of the 61,244 subject adults, 30% already work 80 or more hours a month and 62% are not working. 24% have a child under 14 at home. Among those not working, 50% report a disability and 13% are caregivers.
| Characteristic | Share of subject adults |
|---|---|
| Age 19-24 | 13% |
| Age 25-34 | 22% |
| Age 35-44 | 18% |
| Age 45-54 | 17% |
| Age 55-64 | 31% |
| Not working | 62% |
| 1 to 19 hours a month | 1% |
| 20 to 79 hours a month | 6% |
| 80 or more hours a month (meets the bar) | 30% |
| Not working: Disabled | 50% |
| Not working: Caregiver | 13% |
| Not working: Postpartum | 0% |
| Not working: Student | 2% |
| Not working: Other | 35% |
Why eligible people lose coverage
Of the 35,542 projected to lose coverage in Alaska, 33,704 meet the requirement or qualify for an exemption but fail to document it. 7,478 of those are working people who cannot prove their hours through data the state can see, and 26,227 qualify for an exemption the state does not detect automatically.
| Group | Projected to lose coverage |
|---|---|
| Variable shifts / on-call work | 2,051 |
| Self-employed (other) | 1,721 |
| Multiple part-time jobs (aggregation failure) | 1,326 |
| Volunteering / job training | 678 |
| Seasonal: agriculture, hospitality, food service | 570 |
| Cash-paid construction & trades | 495 |
| Full-time students not auto-verified | 485 |
| Gig / courier (DoorDash, Uber, Lyft, Instacart) | 152 |
| American Indian / Alaska Native (tribal exemption) | 14,078 |
| Medically frail without auto-match | 6,096 |
| Caregivers of a disabled adult | 2,420 |
| SUD treatment not flagged in claims data | 1,162 |
| Kinship caregivers (non-parent) of children ≤13 | 951 |
| Parent caregivers of children ≤13 without auto-match | 608 |
| Recent incarceration (data-match gap) | 566 |
| Other categorical exemptions (foster, AYA cancer, SNAP/TANF) | 316 |
| Pregnancy / postpartum data lag | 31 |
Can the state renew people automatically?
The ex parte capability index blends the state's observed automatic-renewal rate (60% in CMS eligibility-processing data), the wage, disability, and other data sources it can query, and its history of churn. Alaska's composite score is 57 (mid band). A low score means more eligible people will be dropped for paperwork unless the state changes its process before January 1, 2027.
| Component | Score |
|---|---|
| Composite | 57 |
| Observed ex parte | 60 |
| Core capability | 18 |
| Data sources | 55 |
| Historical churn | 50 |
How subjects overlap across exemption categories
| Combination | Adults | Share |
|---|---|---|
| None of the four | 30,051 | 49.1% |
| Working ≥ qualifying hours / income | 13,756 | 22.5% |
| Medically frail | 10,750 | 17.5% |
| Working ≥ qualifying hours / income + Parent caregiver of child ≤13 | 2,196 | 3.6% |
| Working ≥ qualifying hours / income + Full-time student | 1,639 | 2.7% |
| Full-time student | 970 | 1.6% |
| Parent caregiver of child ≤13 | 843 | 1.4% |
| Working ≥ qualifying hours / income + Medically frail | 829 | 1.4% |
State brief and methodology
Estimates, not counts. The model rakes to CBO's national subject total and allocates by ACS microdata; state agencies hold the administrative data that would replace these figures.