Nick Begich III voted for the first law that takes Medicare away from people who already have it. He cast that vote on July 3, 2025. The law drops lawfully present immigrants who lack green cards, such as refugees and asylees. By 2034, about 100,000 people lose Medicare, the Congressional Budget Office projects.
In May 2025 Begich's vote was the margin for the House bill. It froze two rules meant to help low-income seniors get their Medicare premiums paid. His April 2025 vote decided the budget plan that made room for the tax cuts. In the final law, those cuts pull Medicare's hospital fund shortfall one quarter sooner within 2033. Alaska has 118,047 people on Medicare.
Nick Begich III's Votes That Reach Medicare
- Begich Voted for the First Law to Strip Medicare From People Already Enrolled. Nick Begich III voted for final passage of H.R. 1 on July 3, 2025. It carried 218 to 214. Under section 71201, lawfully present immigrants without green cards lose Medicare. Refugees and asylees are among them. KFF notes that "This is the first time that Congress has eliminated Medicare coverage" for eligible people. The Congressional Budget Office sees "0.1 million Medicare beneficiaries losing their Medicare coverage as of 2034," per KFF. The Center for Medicare Advocacy says CMS's proposed rule would end coverage for people identified in the grace period on February 1, 2027.
- Begich's Deciding Vote Froze Rules That Help Poor Seniors Pay Medicare Premiums. Begich gave the House bill its winning margin on May 22, 2025. The tally was 215 to 214, with one present. Without him it would have failed. The bill, and later the law, halted most of two rules that eased enrollment in the programs covering Medicare premiums for low-income seniors. An earlier Congressional Budget Office estimate, made for the House bill, put the cost of the delay at 1.3 million fewer Medicare enrollees covered by Medicaid in 2034. KFF estimates that a senior cut off from that help could end up "paying $185 per month in Medicare premiums, or about 20% of income."
- Begich Decided the Budget Plan Whose Tax Cuts Drain Medicare's Hospital Fund Sooner. On April 10, 2025, Begich voted yes on the final H.Con.Res. 14. It passed 216 to 214. A flip by Begich alone would have meant a tie, and a tie would have failed. The resolution let Ways and Means write tax cuts that "increase the deficit by not more than $4,500,000,000,000". The final law Begich voted for in July lowers the income tax on Social Security benefits. Some of that tax revenue goes to Medicare's hospital coverage. The trustees now expect the hospital fund to run dry in 2033, one quarter sooner. KFF says the main reason is revenue "lower than previously projected due to changes in the 2025 budget reconciliation bill".
What Nick Begich III's Votes Mean for Medicare in Alaska
- 118,047 Alaskans rely on a hospital fund the law drains faster. Alaska had 118,047 people on Medicare in 2024, KFF reports. Nearly all of them, 114,940 or 97%, use traditional Medicare. Each needs a hospital trust fund now projected to run out in 2033.
- 13,500 Alaska seniors are on Medicaid, the program behind premium help. In 2025, 13,500 seniors in Alaska's at-large district were enrolled in Medicaid, KFF data show. Medicaid is what covers Medicare premiums for poor seniors. The law froze rules meant to make that help easier to get.
- Some lawfully present Alaskans lose Medicare in February 2027 under CMS's proposed timeline. Alaska's refugees and asylees on Medicare fall under the cutoff. The Center for Medicare Advocacy reads CMS's proposed rule as ending Medicare on February 1, 2027 for Alaskans flagged in that window. After that, a hospital stay or a doctor's bill is theirs to pay.
Frequently Asked Questions About Nick Begich III on Medicare
What is Nick Begich III's record on Medicare under Trump?
Nick Begich III voted on July 3, 2025, for a law that cancels Medicare for some lawfully present immigrants; Congress had never before removed such coverage. His May 22 vote gave the House version its one-vote margin. That bill froze rules that help low-income seniors get premium aid. His April 2025 budget vote, also decisive, cleared the way for the law's tax cuts, which pull the hospital fund's shortfall one quarter sooner within 2033.
Did Nick Begich III vote to make Medicare pay more for some drugs?
Yes. Nick Begich III voted for the law that widens the orphan-drug exemption from Medicare price talks. The Congressional Budget Office puts the added Medicare cost at $8.8 billion. KFF expects talks on the cancer drugs Keytruda and Opdivo to slip "by at least one year". In 2023, "Medicare and beneficiaries spent $5.6 billion on Keytruda and $2.0 billion on Opdivo."
Did Nick Begich III vote for changes that bring Medicare hospital payment cuts closer?
Yes. Nick Begich III voted for the final law, whose tax cuts move the hospital fund's depletion up by one quarter within 2033; his deciding April 2025 budget vote made room for them. At that point, the Committee for a Responsible Federal Budget says, the trustees project "an 11% cut in hospital payments, growing to a 16% cut by 2040." That cut lands on every hospital that treats Alaska's 118,047 Medicare enrollees.
Last updated: 2026-10-27