Representatives from two organizations helping Alaskans sign up for health insurance report that the second open enrollment period is off to a good start. HealthCare.gov is working much better now than in the fall of 2013, and navigators with Enroll Alaska and United Way were successful in helping consumers enroll in health plans during the first weekend of 2015 open enrollment.
While the malfunctioning HealthCare.gov was a challenge to 2014 enrollment in Alaska, this year’s concern is a spike in premium costs. Rising premiums are nothing new. Premiums for individual insurance in Alaska have increased about 12 percent annually over the past five years. However, the increases are even bigger for 2015.
The good news is that the subsidies, which are available to the majority of those who use the exchange, will limit the pain for many people.
Most will be shielded from increases
Alaska insurance officials announced significant premium increases for 2015: 35 to 40 percent for policies sold by Premera Blue Cross and 22 to 29 percent for policies sold by Moda Health. According to Avalere Health, a consulting company, Alaska had the biggest increase in the nation: 28 percent.
Insurance Commissioner Lori Wing-Heier said the rate increases are justified. The state’s small population and limited marketplace enrollment makes for a small risk pool. With high claim costs and few people to spread those costs across, insurance companies are raising rates to cover their expenses.
While the rate increases are certainly a burden for some, the impact will be felt by a minority of consumers. Wing-Heier pointed out that people who qualify for subsidies — 88 percent of Alaskans using the exchange in 2014 — won’t bear the brunt of those increases.
A report released in June by the U.S. Department of Health and Human Services showed Alaskans who received subsidies qualified on average for an 81 percent reduction in their premiums. The average monthly premium, after tax credits, for Alaska consumers is $94 in 2014, and 42 percent of Alaska enrollees who receive subsidies pay $50 or less per month.
Varied approach to ‘grandmothered’ plans
The two insurers participating in the marketplace are split in their approach to “grandmothered” health plans — plans that don’t comply with ACA but were granted a temporary extension. While the state authorized the extension of the non-compliant plants, the individual carriers get to decide if they will continue to offer them. Premera Blue Cross will continue its grandmothered plans in 2015, but Moda Health will not. About 800 people will have to pick a new plan for 2015.
Signups during first enrollment period
Fewer than 13,000 Alaskans enrolled in private health insurance through the federal marketplace during the 2014 open enrollment period. Just Wyoming, the District of Columbia, North Dakota, and Hawaii had lower enrollment in private health plans. About 4,200 people qualified for Medicaid or the CHIP. Alaska’s uninsured rate remains high at nearly 19 percent.
Among Alaska residents selecting a QHP, 88 percent qualified for financial assistance, compared to 85 percent nationally. A report released in June by the U.S. Department of Health and Human Services showed the average monthly premium, after tax credits, for Alaska consumers was $94. Among states using the federal marketplace, the average was $82. Forty-two percent of Alaska enrollees pay $50 or less per month after subsidies.
Twenty-seven percent of Alaska residents selected a bronze plan (20 percent nationally), 65 percent selected a silver plan (65 percent nationally), 8 percent selected a gold plan (9 percent nationally), 0 percent selected a platinum plan (5 percent nationally) and 1 percent selected a catastrophic plan (2 percent nationally). Twenty-nine percent of Alaska enrollees were between the ages of 18 and 34.
Alaska’s position on exchange, Medicaid expansion
Alaska is among the 26 states that opted to use the federal health insurance marketplace. Alaska refused all federal funding to evaluate and implement a health insurance marketplace, and it was one of the first states to announce it would leave responsibility for its marketplace in the hands of the federal government. While former Gov. Sean Parnell officially announced his decision in July 2012, he had previously made his opposition to the Affordable Care Act, which mandated the exchanges, well known.
Parnell also opposed expanding the Medicaid program. He rejected an expansion in late 2013, saying the Alaska wouldn’t be able to afford the program if the federal government were ever to cut funding. (The federal government will pay 100 percent of Medicaid expansion through 2016 and 90 percent through 2020.) In January, Democrats proposed legislation to expand Medicaid, and they included a provision to return to the current eligibility standards if federal funding drops below 90 percent. Even with that safeguard, the bill did not make it out of committee before the legislature adjourned.
However, the new governor — Bill Walker — has vowed to reverse the course on Medicaid expansion. Walker took office Dec. 1 and announced his intention to authorize expansion within his first 90 days in office through either an executive order or collaboration with the Legislature.
If the state authorizes expansion, about 30,000 Alaskans would qualify for Medicaid according to the Kaiser Family Foundation and the state would receive about $2.1 billion in federal funding through 2020 according to an Urban Institute study.
Alaska health insurance exchange links