Alaskans shopping for individual health insurance on the federal exchange will only be able to choose from one insurer when open enrollment starts on November 1st.
Premera Blue Cross Blue Shield of Alaska is increasing premiums an average of 7.3 percent.
State officials are trying to head off bigger price increases in the future.
Juneau Montessori School teacher Laurie Clark loves working with toddlers. But the 61-year-old is not sure how much longer she can afford to do it. Her job doesn’t provide insurance. And she’s paying $1,500 per month for individual health insurance, three times what she paid last year in New Mexico.
“What choice do I have? I could be uninsured and take a risk of not being able to afford health care, or hospitalization, or visits to a doctor,” she said. “I just wasn’t — you know, I’m not a risk taker. I didn’t want to do that.”
High insurance premiums are a problem in the state. For example, Premera had increases of 37 and 38 percent the last two years. And four companies have dropped out of the insurance exchange, citing an inability to offer competitive premiums that would cover their health costs.
There are two reasons. Health care just costs more in Alaska than in other states. The other reason is a lot of Alaskans with existing health problems buy plans on the exchange, which is a central feature of the federal Affordable Care Act.
Alaska Division of Insurance Director Lori Wing-Heier says the state government wants to attract more insurers.
“It’s good for consumers to have a choice, so that they can compare plans, compare services, compare the providers, and elect who they want to basically contract their health care insurance with,” Wing-Heier said. “And at this point in time, consumers in Alaska in the individual market will not be able to do that.”
The first step the state took was a law introduced by Gov. Bill Walker and passed by the Legislature. It provided $55 million in reinsurance to offset Premera’s individual insurance costs in 2017 and 2018. Premera estimated it helped lessen its premium increase from nearly 10 percent to 7.3 percent.
Some legislators say they don’t want to pay insurers beyond 2018.
So, Wing-Heier is looking for a permanent source of funding for individual market reinsurance. A federal “innovation waiver” could help. The state plans to apply for the waiver to relax some federal rules regarding reinsurance. Wing-Heier says finding a long-term solution is important.
“I think you will see insurance companies look to come to Alaska, because they know that those large losses are going to go to the reinsurance program, and that there is a way that they can price the insurance where they can at least break even – if not make a small profit,” Wing-Heier said.
Premera spokeswoman Melanie Coon says the company is committed to Alaska. But she says it will remain a challenge to control premiums, without a long-term fix.
“You’re still trying to spread very large costs across a very small population,” she said.
It can be a tough sell. While most Alaskans qualify for federal tax credits that lower their individual insurance premiums to less than $75 a month, those who don’t qualify face high costs.
Juneau insurance agent Alan Plotnick of Shattuck and Grummett Insurance says his clients are sometimes shocked by the cost of individual insurance. Some choose to pay a penalty fee of 2.5 percent of their income instead of buying insurance. Others qualify for a federal hardship exemption from the fee.
“I’ve had somebody go to tears before because they just simply can’t afford it, and ended up not being able to get a plan,” Plotnick said. “Sure, they can file for the hardship and get an exemption from the fee, but that doesn’t help them get a plan and have the peace of mind of having good health insurance coverage. And that breaks my heart.”
Laurie Clark is one of Plotnick’s clients. She says she wants to stay in her teaching job. But she may have to reconsider – she’s paying more for insurance each month than for her home.
“It’s just amazing that all of my life, I had health insurance,” Clark said. “And I never thought I’d be in this position.”
The Division of Insurance is aiming to file for the innovation waiver by Oct. 31.