Alaska health insurance

Health insurance in Alaska

● Alaska has chosen to use the federal health insurance market to enroll in the exchange, so residents will HealthCare.gov.

● Open enrollment for 2021 coverage in Alaska ended on December 15, 2020. Alaskans with qualifying events can sign up or make changes outside of that window.

● Short-term health insurance in Alaska can have initial plan terms of up to 364 days; Alaska is unable to meet federal short-term health insurance rules.

● Two insurers - Premera and Moda - offer medical insurance in return in Alaska.

● Alaska adopted the ACA's Medicaid expansion in 2015. Nearly 61,000 people have coverage under expanded eligibility rules (compared to 48,000 at the end of 2019, with enrollment growth likely linked to the COVID-19 pandemic).

● Nearly 105,000 Alaskans were enrolled in Medicare as of August 2020.

This page is designed to help you find health insurance resources in the state of Alaska. We've included an overview of the health insurance market in Alaska, where individuals and families can buy coverage and get subsidies that make it more affordable. We also summarized Alaska's path to Medicaid expansion and how short-term health insurance works in the state. You'll also find an overview of Medicare in Alaska, plus links to comprehensive guides to open enrollment for individual/family coverage and Medicare.

Alaska's health insurance marketplace

Because of the ACA, each state has a health insurance marketplace (also known as exchange). The market is where individuals and families can buy private health insurance, with subsidies available depending on income. People who shop for their coverage include the self-employed, early retirees, and people employed in a small business that does not provide health benefits to employees.

Alaskans can also use the market to enroll in Medicaid if they are eligible based on income only.

Alaska's health insurance marketplace is operated by the federal government, and residents sign up HealthCare.gov. The state refused federal funding to create its own market, and was one of the first states to announce that it would leave its market accountability in the hands of the federal government.

Premera and Moda are the only insurance companies currently offering coverage in Alaska's health insurance market. Moda returned to the exchange at the end of 2020, after exiting the marketplace at the end of 2016. Premera's rates remained broadly unchanged from 2019 to 2020, although there was a very small average rate decrease.

For 2021, Moda proposed a slight (0.11 percent) rate increase for its individual market plans, while Premera proposed a reduction of more than 4 percent.

Alaska Open enrollment period and dates

Open enrollment for Alaska 2021 health insurance plans ran from November 1 to December 15, 2020, with all plans starting January 1, 2021. The open sign-up window is an opportunity for people to sign up for coverage recently and for existing subscribers (both on and off the exchange) to compare available options and renew or change coverage for the following year.

Residents with qualifying events can register or make changes to their coverage outside of open enrollment, depending on their circumstances.

Do you have any questions about open enrollment for individual/family health plans? Our open membership guide can help.

Please note that the sign-up window from November 1st to December 15th applies only to plans purchased in the individual/family market. Employers set their enrollment periods open for employees to make changes to their coverage (these windows are often in autumn, but can be at any time during the year). And there is a different open enrollment period that applies to Medicare beneficiaries. Medicaid enrollment is available year-round for eligible people.

Medicaid expansion in Alaska

Alaska decided not to expand Medicaid for 2014, and a kaiser family foundation study estimated that 30,000 Alaskans were excluded from coverage as a result.  But Governor Bill Walker took office on December 1, 2014 and made expanding Medicaid coverage a priority in his early months.

On July 16, 2015, Walker used his executive authority to expand Medicaid coverage on his own, and the Alaska Medicaid expansion went into effect on September 1, 2016.

From late 2013 to May 2020, enrollment in Medicaid plans grew by 88 percent. The state maintains a page showing details about Medicaid expansion; as of November 2019, there were 48,150 Alaskans covered by the ACA's expanded Medicaid eligibility rules. This had grown to 60,810 by the end of August 2020, reflecting the increase in Medicaid enrollment seen in many states due to job losses resulting from the COVID-19 pandemic.

Short-term health insurance in Alaska

Alaska doesn't have state-specific regulations regarding the duration of short-term health insurance plans, so the state is not in compliance with short-term federal rules. Insurers are allowed to offer short-term plans with initial terms of up to 364 days and the ability to renew for a total duration of up to 36 months.

How did Obamacare help Alaska?

While the ACA is credited with a sharp decline in the uninsured rate across the nation, the impact in Alaska has started more modest. Alaska's unsinsured rate fell 2.8% during the 2014 open enrollment period, from 18.9% to 16.1%.

Alaska expanded Medicaid coverage in September 2016, nearly two years after several other states implemented medicaid expansion. And the state's uns insured rate had fallen to 12.6% by 2018 and 12.2% by 2019. At that point it was still well above the national average of 9.2%.

As of December 2020, there were nearly 17,000 people enrolled in private health plans through the Alaska exchange. All had coverage for the ACA's essential health benefits, and 84% received subsidies for premiums that reduce the monthly cost of the premium. Nearly a quarter of enrollees also received cost-sharing reductions, which help reduce out-of-pocket medical costs.

Alaska and affordable care act

Alaska's three-member U.S. Congress voted 2-1 against the Affordable Care Act, which was signed into law in 2010. Senator Mark Begich, a Democrat, was the only one supporting the ACA. Senator Lisa Murkowski and Representative Don Young, both Republicans, voted no. Former Governor Sean Parnell opposed the general ACA and strongly opposed a state-run exchange.

Senator Dan Sullivan, a Republican who talked about the need to repeal and replace Obamacare, defeated Begich in the 2014 election, so the entire U.S. Congressional delegation is Republican. Everyone is against the ACA, but Senator Murkowski joined GOP Senators Susan Collins (Maine) and John McCain (Arizona) in voting against a bill to repeal the ACA in 2017, clearly killing ACA repeal efforts in the Senate.

Alaska is the only state that has not applied for the $1 million trade planning grant available from the federal government. State lawmakers considered a state-run exchange in the 2011 and 2012 sessions, but failed to pass a bill in either year. Parnell announced in July 2012 that the state would default on the federally facilitated exchange.

Initially, Alaska did not adopt the Medicaid expansion. Governor Bill Walker, an independent, took office on December 1, 2014 and announced his intention to expand Medicaid within his first 90 days in office. Although it took a little longer, it succeeded and the state expanded Medicaid on September 1, 2015.

Does Alaska have a high-risk pool?

Before the ACA reformed the individual health insurance market, coverage was underwritten in nearly every state, including Alaska. This meant that medical history was an important component of eligibility for a private individual plan, and people with pre-existing conditions often found themselves unable to purchase coverage or were only able to obtain a policy that excluded pre-existing conditions.

The Alaska Comprehensive Health Insurance Association (ACHIA) was created in 1993 to offer people an alternative if they were unable to obtain individual health insurance due to pre-existing conditions.

As a provision of the ACA, all new health insurance policies became a guaranteed issue as of January 1, 2014. This reform has largely eliminated the need for high-risk pools, but the pool is still operational and serves as a way for disabled Medicare beneficiaries under the age of 65 to get additional coverage, as Medigap plans in Alaska do not have to make their plans available to enrollees under the age of 65.

But Alaska's assessment of insurers to fund ACHIA is now being used to fund the Alaska Reinsurance Program.

Medicare coverage and enrollment in Alaska

There were 104,734 Alaskans enrolled in Medicare plans as of August 2020.

In Alaska, Medicare plans spent an average of $6,846 in writing - the second lowest in the nation in 2016.

Medicare Advantage plans are an alternative to Original Medicare, used by more than a third of Medicare beneficiaries nationwide. But in Alaska, there are no individual Medicare Advantage plans for sale. Only 1% of Medicare beneficiaries in Alaska have Medicare Advantage plans, and these people are enrolled in employer-sponsored Medicare Advantage coverage.

Alaska Health Insurance Resources

● AK Health Reform - An initiative that provides research, data and analysis on the state of health care in Alaska.

● Denali KidCare

● United Way of Anchorage — The federally funded Navigator organization in Alaska; can provide enrollment assistance with Medicaid and private plans in the exchange.

● Alaska State Health Insurance Counseling and Assistance Programs (SHIP) - A local service that provides enrollment advice and advice to Medicare beneficiaries and their caregivers.

● Medicare Rights Center - A national service that can provide information and assistance to consumers who have questions related to Medicare.

Alaska Comprehensive Health Insurance Association - created by the Alaska State Legislature to provide access to health insurance coverage to all residents of the state who are unable to obtain individual health insurance.