OPINION:
Rural America represents 20% of our nation’s population but covers nearly 97% of our land. These are the communities and people that sustain our farms, our fisheries, and our frontiers. But when it comes to healthcare opportunities for rural America, there are often many challenges that limit access to quality healthcare in rural parts of the United States.
In Alaska, 86% of our communities can’t be reached by road. For many, the nearest hospital is hundreds of miles away, reachable only by plane or boat. For families in rural Alaska, access to healthcare becomes a matter of weather, distance, time, and cost.
Rural communities in the Last Frontier also face a shortage of clinics combined with staffing challenges. According to a 2023 report from the Alaska Hospital and Health Care Association, Alaska needs more than 9,000 healthcare workers every year just to meet basic staffing requirements. That gap is staggering, and it’s growing.
Recruiting and retaining healthcare professionals is uniquely challenging. In some communities, there are no full-time physicians, leaving entire regions reliant on a patchwork system of itinerant providers. That instability has real consequences. Expecting mothers often relocate weeks before giving birth to ensure they’re near a hospital. And in emergencies, families depend on medevac flights to transport them to the closest hospital.
Alaska’s geography demands innovation. And while distance will always be a reality of life in the Last Frontier, we can close the gap in care by investing in solutions designed for rural life.
To meet the needs of communities disconnected from the road system, we must continue expanding modern digital and telehealth infrastructure. Strengthening broadband and secure telemedicine tools will allow every village clinic to connect with specialists in Anchorage, Fairbanks, or anywhere in the country. That kind of access is transformative. It means fewer costly medevacs, faster diagnoses, and care that reaches people where they are.
But technology alone isn’t enough. We also need sustained investment in workforce development to train and support health aides, behavioral health practitioners, and other local providers who understand the communities they serve. These professionals are often the first and sometimes the only point of care in rural Alaska. Expanding this workforce is essential to improving continuity of care and easing the strain on overburdened clinics.
Thankfully, progress is being made.
Earlier this year, Congress secured funding in the Working Families Tax Cuts for the Rural Health Transformation Program - one of the most promising opportunities in decades for rural health. This $50 billion investment was specifically designed to address the challenges rural communities face, helping states attract and retain healthcare providers, expand telehealth infrastructure, modernize outdated clinics, and support innovative care models tailored to local needs. For Alaska, it offers the chance to build a healthcare system that finally reflects our geography and delivers sustainable access to care.
Access to healthcare for veterans in rural communities is one of the clearest examples of both the challenge and the opportunity before us. Alaska is home to over 59,000 veterans 8% of our population. That is the highest percentage of veterans in the United States. Many live in communities accessible only by air, which means delays in care or canceled appointments can have life-altering consequences.
The Veterans’ ACCESS Act of 2025 — legislation currently before Congress — would expand the Veterans Community Care Program and ensure veterans can receive high-quality care from local providers without months of red tape. It would improve scheduling, grow provider networks, and ensure the VA serves veterans.
For Alaska’s veterans, this means fewer canceled flights, quicker referrals, and care that reflects the realities of rural life. This legislation is common sense: if a veteran can be treated in their own community, they should not have to travel hundreds of miles for that care.
When we build a healthcare system that works for every part of Alaska, we strengthen the entire state. Importantly, Alaska’s challenges are America’s rural challenges — just multiplied by distance, weather, and geography. What we build here, from telehealth systems to community-driven care and innovative workforce models, can guide a national approach for improving rural healthcare in all corners of America.
• Rep. Nick Begich was sworn into Congress on Jan. 3, 2025. Nick’s goal in Congress is to make sure Alaskans succeed. He is a member of the House Committee on Natural Resources, where he serves as vice chair of the Energy & Mineral Resources Subcommittee.
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