Nick Begich III voted for Medicaid work rules that federal regulators expect to cut enrollment by 2.3 million people in their first year. His vote for the final law came on July 3, 2025. A disabled expansion adult must qualify for an exemption, which the state can confirm from its own data or from paperwork. Separately, Alaska Medicaid covered 11,500 people through its disability group in 2025.
Begich's votes also decided both 2025 budget resolutions. They set Medicaid's committee a savings target of at least $880 billion. Home care, the service that keeps many disabled Alaskans out of institutions, is the kind of optional benefit most exposed to cuts. Alaska already had 734 people waiting for it in 2026.
Nick Begich III's Votes on Medicaid for People With Disabilities
- Begich Voted to Make Disabled Expansion Adults Prove They Are Exempt From Medicaid Work Rules. On July 3, 2025, final passage of the One Big Beautiful Bill Act drew a yes from Nick Begich III; it carried 218 to 214. In May he was one of the 215 votes that beat 214 for the House version. The law makes covered adults log 80 hours of work or a similar activity each month. Its disability exemptions include a person who is "blind or disabled (as defined in section 1614)" and one "with a physical, intellectual or developmental disability that significantly impairs their ability to perform 1 or more activities of daily living", exemptions a state may check against records it already holds or through forms. Federal Medicaid officials, in their final rule, project that "enrollment would be reduced by 2.3 million individuals in FY 2027." A disabled adult who misses a form or a deadline is counted among them.
- Begich's Deciding Budget Votes Set Up the Medicaid Cuts That Experts Expect to Stall Home Care. H.Con.Res. 14 drew Begich's yes on February 25, 2025, and passed 217 to 215. He voted for its final form on April 10, 2025, when it passed 216 to 214. One switch from Begich would have tied either vote, and a tie kills a resolution. The plan told Medicaid's committee to "reduce the deficit by not less than $880,000,000,000" across ten years. Home and community-based services keep disabled people in their own homes instead of nursing facilities. They are "largely an optional Medicaid benefit," the Bipartisan Policy Center notes, and so "more vulnerable to reductions during periods of state or federal budget constraints". Experts expect the law to "slow or reverse recent HCBS expansion efforts" in the states.
What Nick Begich III's Votes Mean for Alaskans With Disabilities
- 11,500 Alaskans with disabilities count on Medicaid. Of the 210,400 Medicaid enrollees in Alaska's at-large district in 2025, 11,500 were people with disabilities, KFF data show. Their Medicaid care is the care the law's $2.015 billion cut for Alaska reaches.
- 18,905 Alaskans must file paperwork or lose Medicaid. The Alaska health department's model finds 18,905 expansion adults who are not exempted automatically and must report by hand. Disabled Alaskans whose exemption the state cannot confirm on its own are in that group. The model projects 9,452 to 13,611 Alaskans losing coverage.
- 734 Alaskans are on the home care waiting list. Alaska had 734 people waiting for Medicaid home and community care in 2026, KFF reports. For a disabled Alaskan, that wait can mean staying in a facility or relying on family. The Medicaid cuts set up by the budget plans Begich decided leave that optional care more exposed to state cutbacks.
- 9,901 disabled Alaska workers draw Social Security disability benefits. At the end of 2024, 9,901 Alaskans received Social Security as disabled workers. The law speeds up the date the combined retirement and disability trust funds run short, the chief actuary found.
Frequently Asked Questions About Nick Begich III on Disability rights
What is Nick Begich III's record on disability rights under Trump?
Nick Begich III voted on July 3, 2025, for Medicaid work rules requiring disabled expansion-group adults to prove they are exempt, and his May vote gave the House version its one-vote win. Regulators project the rules will cut enrollment by 2.3 million in 2027. The two 2025 budget resolutions each passed on Begich's deciding vote, and the Medicaid cuts they set up put home care at risk. Alaska Medicaid also covers 11,500 people with disabilities through its disability group.
Did Nick Begich III vote for Medicaid work rules that have pushed eligible people off coverage before?
Yes. Nick Begich III voted for the 2025 law that brings work rules to Medicaid nationwide. When Arkansas tried a work requirement, the result was "over 18,000 people losing coverage," KFF found. Alaska's own model expects 9,452 to 13,611 people to lose coverage once the rule starts in January 2027.
Did Nick Begich III vote for budget plans that threaten Medicaid home care in Alaska?
Yes. Both 2025 budget votes Nick Begich III decided, in February and April, set up the Medicaid cuts. States facing that squeeze have reached for "limits on hours or visits, reduced provider payment rates, and new or lower spending caps" on home care, the Bipartisan Policy Center found. Alaska's waiting list already held 734 people in 2026.
Last updated: 2026-10-27