Alaska Medical Professionals Oppose Repeal of 80th Percentile Rule
Changes to the longstanding Alaska policy known as the 80th percentile rule is facing clear opposition from medical professionals across the State. The proposed rule change, being pushed by a major health insurance provider and the Alaska Division of Insurance, seeks to change the rule that’s been in place since 2004. Jill Gaskill, a MD at Anchorage-based Medical Park Family Care, wrote in public testimony to the State of Alaska:
I am writing to express opposition to the repeal of Alaska's 80th percentile rule. I am a primary care physician in Anchorage. I own my practice and my practice is in network with all major insurers.
I have no direct financial benefit from the 80th percentile rule, however it impacts my patients. My business is in caring for the whole patient and economic well-being is a huge factor in influencing overall health for Alaskans. Alaskans need the confidence that their health insurance plan will cover the costs of illness when they become seriously ill.
When people are sick and vulnerable, they don't always have choices about finding the "in network" provider, or they may need a highly specialized provider where no one is in their insurance network. The 80th percentile rule limits the out-of-pocket costs to the patient in dire situations where decisions can't be made based on who is "in network."
As you may recall during the height of the Covid-19 pandemic, sometimes the hospital you went to was in another town, it may have been the only place with a bed or a ventilator. The other major concern for primary care physicians is access to specialty care. We need local resources. There are many medical specialties with very limited representation in Alaska, particularly in the area of pediatric medicine. Flying to Seattle for specialty care does not improve the health of our communities, nor does it bode well for recruiting young people to return to Alaska to start careers and raise families.
The population is aging and we need families and working adults to ensure a healthy economy and healthy communities. People very definitely factor in health insurance costs, coverage and available care when they decide where to move. Don't be short sighted and accept the argument that the 80th percentile rule is driving up Alaska's health care costs. The data being trotted out are old, and there has been no meaningful public discussion of the financial impact of most specialists in Anchorage going in network with the health insurance companies. Health care is changing rapidly. There is downward pressure on reimbursement for services of all kinds, including primary care. We don't want to return to an Alaska like the 1970s and 80s where people are forced to go "Outside" for medical care. I have lived my whole life here and am committed to caring for my community, I've been in private practice for 14 years and plan to continue, but only as long as resources for providing quality care are available.
