Frequently asked questions about health insurance
coverage options in Alaska
Alaska’s health insurance marketplace is run by the federal government, and residents enroll via HealthCare.gov, or via an approved enhanced direct enrollment entity.
Alaska 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.
Learn more about Alaska’s health insurance marketplace.
To address the COVID pandemic and the additional premium subsidies created by the American Rescue Plan, there’s a one-time enrollment window that runs through August 15, 2021. Alaska residents can enroll or make a plan change during this window, regardless of whether they have a qualifying life event.
This enrollment window gives people an opportunity to take advantage of the ARP’s larger premium subsidies. Uninsured residents can enroll (and may find that coverage is much more affordable than the last time they checked), and Alaska residents with off-exchange coverage can switch to the exchange, since subsidies are only available via the exchange. Some current exchange enrollees may want to switch plans during the COVID/ARP enrollment window, since the larger subsidies make more robust plans newly affordable for some people.
During the first several weeks of the COVID/ARP enrollment window, 1,164 Alaska residents enrolled in coverage. This was more than three times the number of people who normally enroll during that time of year (when a qualifying event would normally be necessary). And enrollment has likely picked up even more since the ARP’s additional subsidies became available on HealthCare.gov starting in April.
After August 15, 2021, the normal rules will again apply. Alaska residents will need a qualifying event to enroll or make changes to their coverage for 2021 (both on-exchange and directly through Moda or Premera), and open enrollment for 2022 coverage will start on November 1, 2021.
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.
Premera and Moda are the only insurance companies currently offering coverage in the Alaska health insurance marketplace.
Premera was the only insurer offering coverage in Alaska’s individual market from 2017 through 2019. But the market is much more stable than it once was – largely as a result of the state’s new reinsurance program.
As a result of the more stable market environment, Moda returned to Alaska’s exchange in 2020 in the Anchorage area, and expanded their coverage area for 2021 to include Fairbanks North Star Borough, Ketchikan Gateway County, and Prince of Wales Hyder County. Premera’s plans continue to be available statewide.
During open enrollment for 2021 health coverage, 18,184 Alaskans enrolled. Visit our marketplace overview for past enrollment totals.
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% 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% by 2018, and to 12.2% by 2019. This was still well above the national average of 9.2% 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% 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.
Enrollment in exchange/marketplace plans in Alaska peaked in 2016, with more than 23,000 people enrolling during the open enrollment period for 2016 coverage. Enrollment then declined each year through 2020, but increased to more than 18,000 during the open enrollment period for 2021 coverage.
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.
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 November 2020, enrollment in Medicaid plans had grown by 94%. The state maintains a page that shows details about Medicaid expansion; as of March 2021, there were 65,034 Alaska residents covered under the ACA’s expanded Medicaid eligibility rules. That was up from about 48,000 in late 2019, mirroring the increase in Medicaid enrollment seen in many states as a result of the job losses stemming from the COVID-19 pandemic.
Read our overview of Medicaid expansion 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.
There were 106,263 Alaska residents enrolled in Medicare plans as of February 2021.
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. Less than 2% 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.
- 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.
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.