Tribal consortium takes ownership of Alaska Native Medical Center

The Alaska Native Medical Center, the flagship hospital for Alaska Native health, is now owned by the tribes it serves rather than the federal government — a first in the Anchorage hospital's history.

Ownership passed from the Indian Health Service to the Alaska Native Tribal Health Consortium on Aug. 24, ending federal title to the campus. The consortium, governed by 229 federally recognized tribes, announced the completed transfer on Sept. 4 and had pushed for it since at least 2024, when it and other regional health organizations argued in writing that the hospital should be in tribal hands.

Nothing changes for patients — care, eligibility, services and the roles of the organizations that run them all continue as they are, the consortium said. What changes is money. Federal ownership had barred the hospital from a program that pays the facility costs of hospitals that tribes own or lease, and taking title opens that door.

That program is the reason ownership mattered. Under a provision of the Indian Self-Determination Act, a tribe that holds title to a health facility can require the government to lease it and cover costs like rent, depreciation, and operation and maintenance. It has become one of the fastest-growing and most contested expenses in the Indian Health Service's budget: after a 2016 court ruling — in a case brought by Alaska's own Maniilaq Association, one of the consortium's member organizations — the agency lost the ability to cap what it pays. National lease costs ran $111 million in 2023, and the agency's 2026 request jumped to $413 million. Its budget documents have tied that growth to strain on other health accounts, though the agency says the leases now draw on a separate, protected appropriation.

The consortium was already investing in the building before it owned it, its board committing more than $462 million to projects there, including an 80-bed skilled nursing facility due in early 2027 and an expansion of emergency services.

How exactly the hospital changed hands isn't yet a matter of public record. The Indian Health Service has published nothing about the transfer — no press release, no Federal Register notice, no update to its Alaska Area page — and the deed itself hasn't surfaced, leaving open what kind of title passed, whether the government kept any right to take the property back, and whether anything was paid. The law that created the consortium governs who delivers care at the hospital but says nothing about who owns the buildings, and the specific legal route used for the transfer hasn't been confirmed. By contrast, a 2.79-acre parking parcel on the same campus took an act of Congress in 2013 to convey with clean title.

The consortium's announcement is the only account of the transfer so far, and every voice in it is on one side. Board Chair Kimberley Strong and President and CEO Natasha Singh framed it as tribal self-determination carried across generations, and leaders from Southcentral Foundation and Doyon, Limited welcomed it. The announcement thanked the Indian Health Service, its director, the Health and Human Services secretary, and Alaska Sens. Lisa Murkowski and Dan Sullivan. Whether the consortium has yet requested a lease-payment deal for the hospital, and what one would pay, isn't known.