STATE OF ALASKA

Department of Health

Division of Public Assistance

TRANSMITTAL NUMBER:  MC #32

MANUAL:  MAGIModified Adjusted Gross Income Medicaid program

DATE: September 1, 2026

Beginning July 4, 2025 the 2025 Reconciliation Bill (H.R. 1) was signed into law. This law contains several provisions that affect the non citizen requirements of the Medicaid program that are effective October 1, 2026.

We have also made several changes to clarify existing policy as a result of policy questions or suggestions from the field. An overview of the changes are listed below.

If you have any questions, please contact the Policy & Program Development Team at hss.dpa.policy@alaska.gov. 

OVERVIEW OF CHANGES

805(A)    Issuing Medicaid to Eligible Recipients

• Revised section to new process and new design of Medicaid ID cards.

808-2    Qualified Aliens

• Updated the definition list of 'qualified aliens' eligible for Medicaid effective October 1, 2026, to include Lawful Permanent Residents (LPRs), Cuban nationals, and individuals lawfully residing in the U.S. under the Compacts of Free Association (COFA) with Micronesia, the Marshall Islands, and Palau.

808-3    Native Americans Born Outside the United States

• Removed this section due to the federal rule change effective October 1, 2026.

808-4(D)    Aliens Exempt from the Five Year Waiting Period

• Revised this section to remove categories of individuals no longer designated as 'qualified aliens' effective October 1, 2026. 

817-2    Examples of Income Counting for MAGIModified Adjusted Gross Income Medicaid Household Composition

• Corrected Example #5 to align with current Policy.

823-1(A)    Federal Data Services HUB

• Added VLPVerify Lawful Presence as a new HUB Interface.

825(A)    Applications Submitted Through the Federally Facilitated Marketplace

• Clarified that there are two distinct notification obligations regarding the FFMFederally Facilitated Marketplace.

825(B)    Applications Submitted Through DPADivision of Public Assistance

• Clarified that there are two distinct notification obligations regarding the FFMFederally Facilitated Marketplace.