State lawmakers passed two bills on the last day of the legislative session aimed at fulfilling requirements of a federal health care expansion effort included in President Donald Trump’s signature tax- and spending-cuts law, the One Big Beautiful Bill Act.
One of those, House Bill 110, would make it easier for out-of-state doctors, physician assistants, psychologists, social workers and EMS personnel to get licensed in Alaska by joining what are known as interstate compacts.
The Department of Health told federal officials in its application for a share of the $50 billion in funding from the Rural Health Transformation Program that Alaska would join the various compacts. Alaska is on track to receive more than $1 billion from the program over five years.
“This is the Rural Health Transformation Program bill. That's why these compacts are being done — because the administration committed to the federal government that we would pass or attempt to pass a number of these compacts,” said Anchorage Democratic Sen. Forrest Dunbar ahead of a Senate vote.
The bill passed unanimously in the state House, but there was more controversy in the Senate, where it passed 13-7. All of the no votes came from members of the bipartisan majority, a rarity.
Joining a compact means subscribing to a shared set of rules for doctors, EMS providers and so on. Anchorage Republican Sen. Cathy Giessel, a nurse practitioner and the Senate’s No. 2 leader, said Alaska is a unique place and should be able to impose its own rules.
“I don't want to give up that authority to look at these medical professions and what they can do in our state,” Giessel said. “We are the only ones who care about and understand our state's needs.”
Giessel also pointed out that it’s unclear exactly how much money is at stake. State and federal officials have been hesitant to say how much could be lost if Alaska doesn’t join the compacts the state Health Department committed to.
Anchorage Democratic Rep. Zack Fields said lawmakers didn’t hear pushback from the public on most of the compacts during committee hearings. But Fields said there was one exception: an interstate compact for nurses.
“There continued to be, I would just say, a lot of controversy among stakeholders, and that's why we were not able to resolve that particular compact this year,” Fields told colleagues on the House floor.
Backers say joining the nurse license compact would make it easier to fill nursing jobs in Alaska. But skeptics, including the state’s largest nursing union, say there are structural issues driving nurse turnover, like working conditions and staffing policies, and a compact would only mask the issue.
Another bill passed on the final day of the legislative session to address the requirements of the Rural Health Transformation Program allows pharmacists to treat minor or chronic conditions. House Bill 195 passed the House and Senate by wide margins despite concerns from some Republicans that it could expand access to abortion. The attorney general’s office said those concerns were unfounded.
The legislation now heads to Gov. Mike Dunleavy. His office said Dunleavy would evaluate the bills.
