Standing up for Alaska’s 80th Percentile Rule
Lower-48 insurance companies are trying to abolish the 80th Percentile rule, a longstanding State of Alaska regulation used to hold insurance companies accountable and protect patients, families and workers from exorbitant out-of-pocket medical costs and surprise medical billing.
Insurance premiums have skyrocketed over the years and across the country insurance companies have recorded record profits. Yet, at the same time, medical reimbursements for Alaska healthcare providers have decreased. Lower-48 insurance companies are now leading a fight to change Alaska’s healthcare system for their direct benefit; all without adequate or timely data, guarantees for lower health insurance premiums, a replacement that works to protect the Alaska healthcare ecosystem, or proper input and consultation from Alaska’s medical community.
State of Alaska regulators shouldn’t fold to the pressures of the Big, Lower-48 insurance companies. They should be working to preserve the 80th Percentile Rule, one of the few tools available to hold the insurance companies accountable, ensure they pay their fair share, and protect Alaska’s vulnerable healthcare ecosystem.
The Coalition for Reliable Medical Access is made up of a group of diverse Alaska community leaders, small businesses, public and private sector employees, non-profits, medical professionals and concerned citizens with the shared focused of providing reliable access to medical care in Alaska. Together we will advocate for maintaining healthcare quality across our state by preserving the 80th Percentile rule, and emphasizing the positive impacts the rule has had on Alaska’s unique healthcare market and vulnerable populations.
The Coalition for Reliable Medical Access is a nonprofit with a mission to inform and educate Alaskans – including members of the public and policymakers – on issues relating to healthcare in Alaska, with a particular focus on the ramifications of repealing the 80th Percentile Rule without adequate and timely data, and a replacement that works for the Alaska healthcare ecosystem. The Coalition for Reliable Medical Access operates as a 501(c)(3) nonprofit.
Alaska’s 80th percentile rule protects patients
The 80th percentile rule is an important regulation that protects Alaska patients and consumers from predatory practices by insurance companies.
It was adopted by the State of Alaska due to the volume of complaints from Alaskans that their insurance company was not paying their medical bills and Alaskans were left paying more than their health insurance policy promised.
It was designed to ensure insurance companies based outside of Alaska do not pay only part of your medical bill and saddle you – the patient – with the remainder. It protects Alaskans from insurance companies and, more importantly, the 80th percentile rule works.
Why Are Big, Lower 48 Insurance Companies Trying to Repeal the 80th Percentile Rule
This isn’t the first time Big, Lower-48 insurance companies have pushed to eliminate the 80th Percentile Rule. In fact, efforts to repeal the rule failed in 2018. Now, these companies are trying to bypass the public process without an adequate plan for replacement, proper data, or input and public engagement from Alaskan stakeholders.
With so much at stake for our state and its residents, Alaskans should be asking ourselves some of these important questions:
Why are Big, Lower-48 insurance companies trying to takeover the Alaska healthcare system?
Why is Big Insurance trying to bypass the public process and abolish the 80th Percentile Rule without a replacement?
Why are major changes to Alaska’s healthcare system being pushed through despite legitimate concerns from stakeholders, patients and Alaska’s medical community?
Is placing Alaska’s healthcare system entirely into the hands of Big insurance companies the best approach for Alaskan families, workers and communities?
What will repealing the 80th Percentile Rule mean for vulnerable populations like seniors, veterans and rural residents?
Without the 80th Percentile Rule, will you be able to access the same quality specialty care without being forced to leave the state?
Why are major changes to Alaska’s healthcare system being quietly pushed through without proper oversight and public hearings, adequate and timely data and a replacement that works for the Alaska healthcare ecosystem?
State Regulators Depend on Deeply Flawed Information to Justify Repeal
State of Alaska regulators based their decision to repeal the 80th Percentile Rule on a deeply flawed 2018 Institute of Social and Economic Research (ISER) study to conclude the rule was contributing to increased healthcare costs in Alaska. However, the study relied on incomplete and outdated data while also failing to account for Alaska’s dramatically changing demographics. The basis for repeal was also predicated on flawed data produced by FairHealth, a national repository for private claims data, which falsely claim medical reimbursement rates are rising at the same rate of insurance premium increases.
In an effort to reconcile these discrepancies, for the first time in Alaska and possibly the United States, CRMA led cooperation among multiple physician, chiropractic, physical therapy and other practices in Alaska to share, in anonymous fashion, how much insurance has paid them for a given unit of service over the past several years. The chart shows flat or declining reimbursements across the healthcare spectrum for years, simultaneous with skyrocketing insurance premiums.
With this actual Alaska data in hand, it is clear there is no direct relationship between provider fees and health insurance premiums. If anything, this data outlines an inverse relationship, and demonstrates the 80th Percentile Rule is demonstrably not the cause of healthcare cost inflation in Alaska.
