Four groups keep full Medicaid after Oct. 1. Refugees and asylees are not among them.

Refugees, asylees and trafficking victims enrolled in Alaska Medicaid could lose full coverage on Oct. 1. A federal law enacted this year restricts federal matching funds for full Medicaid and children's health coverage to four groups, and states have to bring their programs in line to keep the match. The Alaska Department of Health has filed notice that it will ask federal regulators to amend the state's Medicaid plan accordingly.

The four groups are U.S. citizens and nationals, lawful permanent residents, Cuban and Haitian entrants, and migrants from the Compact of Free Association nations. Refugees and asylees are not among them. Neither are trafficking victims or the Iraqi and Afghan special immigrants who qualify under Alaska regulation, unless they meet an exception.

Before anyone loses coverage, states have to recheck the immigration status of every beneficiary who might be affected. Federal guidance directs them to work from Social Security, Homeland Security and state records first, without contacting the beneficiary. Where those records cannot confirm status, the state has to give the person 90 days to produce documentation.

That makes a current mailing address the thing to check now. Beneficiaries can update their contact information and upload documents through the Alaska Connect portal or by calling the Division of Public Assistance at 800-478-7778.

Emergency Medicaid stays available to otherwise eligible noncitizens who lose full coverage, but it pays only for treating an emergency medical condition — not for primary, preventive or specialty care. A second provision of the same law cuts the federal share of that emergency care from the expansion rate to Alaska's regular rate on the same day, shifting more of the cost onto the state.

About one in three Alaskans is enrolled in Medicaid. The state has until Dec. 31, 2026 to submit its amendment, three months after the coverage change takes effect.