Health insurance in Alaska
- Alaska opted to use the federal health insurance marketplace for exchange enrollment, so residents enroll through HealthCare.gov.
- Open enrollment for 2021 coverage in Alaska will run from November 1 – December 15, 2020. Alaska residents with qualifying events can enroll or make changes outside of that window.
- Short-term health insurance in Alaska can have initial plan terms up to 364 days; Alaska defaults to federal short-term health insurance rules.
- Two insurers – Premera and Moda – offer on-exchange medical insurance in Alaska.
- Alaska adopted the ACA’s Medicaid expansion in 2015. Nearly 61,000 people have coverage under the expanded eligibility rules (up from 48,000 in late 2019, with enrollment growth likely tied 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 marketplace in Alaska, where individuals and families can purchase coverage and obtain subsidies that make it more affordable. We’ve 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, as well as 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 an exchange). The marketplace is where individuals and families can shop for private health insurance, with subsidies available depending on income. People shopping for their own coverage include the self-employed, early retirees, and people employed by a small business that doesn’t provide health benefits to employees.
Alaska residents can also use the marketplace to enroll in Medicaid if they’re eligible based on income alone.
Alaska’s health insurance marketplace is run by the federal government, and residents enroll via HealthCare.gov. The state refused federal funding to create its own marketplace, and was one of the first states to announce it would leave responsibility for its marketplace in the hands of the federal government.
Premera and Moda are the only insurance companies currently offering coverage in the Alaska health insurance marketplace. Moda rejoined the exchange as of 2020, after exiting the marketplace at the end of 2016. Premera’s rates were essentially unchanged from 2019 to 2020, although there was a very small average rate decrease.
For 2021, Moda has proposed a slight (0.11 percent) rate increase for its individual market plans, while Premera has proposed a decrease of more than 4 percent.
Read our full overview of the Alaska health insurance marketplace.
Alaska open enrollment period and dates
Open enrollment for 2021 Alaska health insurance marketplace plans will start November 1, 2020 and run through December 15, 2020, with all plans effective January 1, 2021. The open enrollment window is a chance for people to newly enroll in coverage, and for existing enrollees (both on-exchange and off-exchange) to compare the available options and either renew or change their coverage for the coming year.
Residents with qualifying events can enroll or make changes to their coverage outside of open enrollment, depending on their circumstances.
Got questions about open enrollment for individual/family health plans? Our guide to open enrollment can help.
Note that the November 1 – December 15 enrollment window only applies to plans purchased in the individual/family market. Employers set their own open enrollment periods for employees to make changes to their coverage (these windows are often in the fall, 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 people who are eligible.
Medicaid expansion in Alaska
Alaska decided against Medicaid expansion for 2014, and a Kaiser Family Foundation study estimated 30,000 Alaska residents were excluded from coverage as a result. But Gov. Bill Walker took office on Dec. 1, 2014, and made Medicaid coverage expansion a priority in his first months.
On July 16, 2015, Walker used his executive authority to expand Medicaid coverage on his own and Alaska Medicaid expansion took effect on September 1, 2016.
From late 2013 through May 2020, enrollment in Medicaid plans had grown by 88 percent. The state maintains a page that shows details about Medicaid expansion; as of November 2019, there were 48,150 Alaska residents covered under the ACA’s expanded Medicaid eligibility rules. That had grown to 60,810 by the end of August 2020, mirroring the increase in Medicaid enrollment seen in many states as a result of the job losses stemming from the COVID-19 pandemic.
Read more about Medicaid expansion in Alaska.
Short-term health insurance in Alaska
Alaska does not have state-specific regulations pertaining to the duration of short-term health insurance plans, so the state defaults to the federal short-term rules. Insurers are allowed to offer short-term plans with initial terms up to 364 days and the option to renew for a total duration of up to 36 months.
Read more about short-term health insurance coverage in Alaska.
How has Obamacare helped Alaska?
While the ACA is credited with a sharp decline in the uninsured rate across the nation, the impact in Alaska started out more modest. Alaska’s uninsured rate dropped 2.8 percent during 2014 open enrollment period, from 18.9 percent to 16.1 percent.
Alaska expanded Medicaid coverage in September 2016, nearly two years after many other states had implemented Medicaid expansion. And the uninsured rate in the state had dropped to 12.6 percent by 2018, and to 12.2 percent by 2019. This was still well above the national average of 9.2 percent at that point.
As of 2020, there were nearly 17,000 people enrolled in private health plans through the Alaska exchange. All of them had coverage for the ACA’s essential health benefits, and 84 percent were receiving premium subsidies that reduce their monthly premium costs. Nearly a quarter of the enrollees were also receiving cost-sharing reductions, which help to reduce out-of-pocket medical costs.
Alaska and the Affordable Care Act
Alaska’s three-member U.S. Congressional delegation voted 2-1 against the Affordable Care Act, which was signed into law in 2010. Sen. Mark Begich, a Democrat, was alone in supporting the ACA. Sen. Lisa Murkowski and Rep. Don Young, both Republicans, voted no. Former Gov. Sean Parnell opposed the overall ACA and spoke out strongly against a state-run exchange.
Sen. Dan Sullivan, a Republican who has talked about the need to repeal and replace Obamacare, defeated Begich in the 2014 election, so the state’s entire U.S. Congressional delegation is Republican. All are opposed to the ACA, but Senator Murkowski famously joined GOP Senators Susan Collins (Maine) and John McCain (Arizona) in voting against a bill to repeal the ACA in 2017, effectively killing the ACA repeal efforts in the Senate.
Alaska is the only state that did not apply for the $1 million exchange-planning grant that was available from the federal government. State legislators considered a state-run exchange in the 2011 and 2012 sessions, but didn’t pass a bill either year. Parnell announced in July 2012 that the state would default to the federally facilitated exchange.
Initially, Alaska did not adopt 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. Though it took a little more time, he 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 only able to get a policy that excluded pre-existing conditions.
The Alaska Comprehensive Health Insurance Association (ACHIA) was created in 1993 to give people an alternative if they were unable to obtain individual health insurance because of pre-existing conditions.
As a provision of the ACA, all new health insurance policies became guaranteed issue starting on January 1, 2014. This reform 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 obtain supplemental coverage, as Medigap plans in Alaska do not have to make their plans available to enrollees under age 65.
But Alaska’s assessment on insurers to fund ACHIA is now used to fund the Alaska Reinsurance Program.
Medicare coverage and enrollment in Alaska
There were 104,734 Alaska residents enrolled in Medicare plans as of August 2020.
In Alaska, Medicare plans spent per $6,846 on average per enrollee – 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. Just 1 percent of Alaska’s Medicare beneficiaries have Medicare Advantage plans, and these individuals are enrolled in employer-sponsored Medicare Advantage coverage.
Read more about Medicare enrollment in Alaska, including the state’s rules for Medigap plans.
Alaska health insurance resources
- AK Health Reform – An initiative providing research, data and analysis regarding 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 counseling and advice to Medicare beneficiaries and their caregivers.
- Medicare Rights Center — A nationwide service that can provide information and assistance for 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.
Health reform legislation in Alaska
Scroll to the bottom of this page for a summary of what’s happening at the state level in Alaska with regard to healthcare reform legislation.
Louise Norris is an individual health insurance broker who has been writing about health insurance and health reform since 2006. She has written dozens of opinions and educational pieces about the Affordable Care Act for healthinsurance.org. Her state health exchange updates are regularly cited by media who cover health reform and by other health insurance experts.