On a life-flight from Fairbanks to Anchorage, Sierra Ott’s newborn son Liam would not stop bleeding from a routine needle prick.

Doctors in the Anchorage neonatal intensive care unit diagnosed him with a blood clotting disorder. Without medication, he is at risk of extreme joint pain and even bleeding out from what would not normally be serious injuries.

Ott said that without health insurance from her husband’s military service, the pills would cost the family about $8,000 a month.

At the urging of her case worker, Ott applied for Medicaid for her son’s disability. Liam will have to take the medication for the rest of his life, and she wanted to make sure there would never be gaps in his coverage. In addition to bleeding, hemophilia can cause debilitating joint pain. Ott applied last October.

She is still waiting.

Her family is one of thousands caught in a backlog of Medicaid applications in Alaska. “I know that we’re not the only family who has been waiting for answers that are just not coming,” Ott said.

The Otts filed a class action lawsuit against the state on Thursday with the Northern Justice Project, a civil rights law firm that represents low- and middle-income Alaskans. It alleges the state has failed to provide timely access to Medicaid to eligible Alaskans who have a dire need for health care coverage.

The lawsuit is one of at least four pending against the Department of Health because the state agency is not processing applications for federal benefits in a lawful amount of time.

James Davis, Jr., a founding partner for the Northern Justice Project, said they took on the case because he is fed up with dysfunction in the state agency, which has wrestled with backlogs of crisis proportions since 2022.

“I’ve never in 20 years seen repeated systemic problems of such a broad scope,” he said. “I mean, we’re talking thousands of families waiting for food stamps and thousands of families waiting for Medicaid.”

Davis plans to ask the court for “summary judgment,” or to judge the case without a time-consuming trial. He said he hopes to get relief for families in a matter of months rather than waiting what could be more than a year for a trial.

He said his firm gets about a call a week from families with disabled children that have waited months for the state agency to give them a Medicaid determination. “That entire time they can’t get their children medical coverage,” he said.

In an article from Alaska Public Media that detailed the state’s Medicaid backlog, Division of Public Assistance Director Deb Etheridge said eligible Alaskans can access care as long as they have submitted an application and that Medicaid will retroactively reimburse them.

Etheridge was unavailable for immediate comment on Thursday.

Davis said he was infuriated by the state’s response: “The fact of the matter is, most of us can’t afford to pay out of pocket for our kids — most of us aren’t rich.”