Alaska can't afford these health care bills
Close-up of a nurse pushing patient on wheelchair in hospital. Healthcare worker hand pushing sick patient on wheelchair.
Health care in Alaska is expensive. Some say the most expensive in the country. And it's only getting harder for families and businesses to keep up. Now, two bills in the Alaska Legislature, Senate Bills 121 and 122, could make things even worse. They would raise health care costs for nearly everyone with private insurance, without improving access or quality of care.
At Premera Blue Cross Blue Shield of Alaska, we're very concerned about what these bills would mean for Alaskans.
Some people think these bills would only affect certain types of insurance, like individual plans or small businesses. But that's not true. At Premera, we use one provider network for all of our Alaska customers, whether they buy insurance on their own, get it through a small business, or work for a large, self-funded employer. That means if these bills force us to pay higher prices to providers, everyone's costs go up; not just the people directly covered by the law.
SB 121 would bring back a version of Alaska's old '80th percentile rule.' That rule said insurers had to pay high out-of-network bills, no matter how inflated they were. It led to huge increases in health care costs, and it was finally repealed last year. After the rule was repealed, access to care didn't get worse. In fact, our network of doctors and providers grew. That shows we don't need extreme payment rules to keep providers in the system.
Now, SB 121 proposes a similar rule: insurers must pay providers either the 75th percentile of billed charges or 450% of what Medicare pays, whichever is higher. That would raise costs across the board. We estimate that for a family of four in the individual market, this could mean $5,000 more per year in premiums starting in 2026.
And because we use one network, those increases would hit all of our customers.
SB 122 would force insurers to include almost every provider in the state in their network, even if those providers charge high prices or don't meet our quality standards. It would also limit our flexibility in how we build networks in different regions of Alaska. The end result? Less control over costs, higher prices, and no improvement in the quality of care.
Together, SB 121 and 122 would raise costs for almost everyone in Alaska's private insurance market, including large employers, union trusts, and small businesses. They wouldn't improve access to care or help people get healthier. They would just shift more financial burden onto families and businesses who are already struggling. And in a state where the working-age population is shrinking, asking employers to pay even more for health insurance just isn't realistic.
If lawmakers want to improve access to care, there are smarter ways to do it:
Raise Medicaid payments so providers can keep serving low-income patients
Push for higher Medicare rates that reflect Alaska's true cost of care
Support innovations that improve care while keeping costs under control
Businesses across Alaska face significant challenges in offering good benefits and supporting their employees. Let's keep working together to make health care more affordable for Alaska.
SUBSCRIBE: GET THE MORNING HEADLINES DELIVERED TO YOUR INBOX
Hashtags
Try Our AI Features
Explore what Daily8 AI can do for you:
Comments
No comments yet...
Related Articles
Yahoo
17 minutes ago
- Yahoo
Opinion - We're cancer doctors. Here's why Medicare Advantage fails America's elderly.
'It's nothing,' Tom, a retired firefighter from rural Texas, thought when he had persistent stomach pain. After shedding 30 pounds in three weeks, his family physician ordered a CT scan. Tom was not concerned — after all, the 65-year-old had gotten Medicare Advantage earlier that year. Like millions, Tom switched his insurance after he was solicited by a broker who promised low premiums and a gift card. Absent from the sales pitch was the fact that Medicare Advantage plans — privately run and separate from government-funded traditional Medicare — often delay and deny coverage. One of us met Tom nearly three months after his CT scan, and his doctor discovered the abdominal mass. The job as the first oncologist he had been able to see after months of jumping through hoops was to get initial scans, identify an in-network provider, wait for further referral and approval processes and finally schedule and complete a biopsy. The delays became a death knell. Tom was diagnosed with Stage 3 pancreatic cancer. Tom's first question was, 'It's going to be fine, right?' Despite the urge to reassure him, Tom's life and treatment options were not up to a doctor. They were up to his insurance. The same insurance that delayed urgent testing and care. By definition, Medicare Advantage is meant to support elderly medical care and increase efficiencies; in function, it is a business model that allows the American government to decrease its liability for sick seniors. Instead of absorbing and managing costs, the responsibility is outsourced to third-party operators, such as UnitedHealth Group, Humana and CVS Health. While Medicare Advantage provides excellent coverage if you never get sick, this insurance can quickly become a precursor to medical bankruptcy if the patient develops a deadly disease, a highly probable outcome when you consider that nearly 40 percent of Americans get cancer in their lifetime. After nearly two decades of experimentation and $450 billion of taxpayer money, Medicare Advantage has proven porous in terms of corruption, fraud and abuse. Yet, 32.8 million elderly Americans (54 percent of the eligible Medicare population) are currently enrolled in Medicare Advantage. In 2023 alone, Medicare Advantage plans fully or partially denied 3.2 million prior authorization requests. No one, especially among folks facing the daily drudgery of fighting cancer, truly understands how the cogs within the insurance machine work. Few of our elderly patients fight the goliath institution, and many succumb to poorer health outcomes in their quest for lifesaving treatment. Last year, countrywide and across disease groups, 79 percent of patients who experienced a delay or denial of coverage paid out of pocket for medication at least sometimes. Unsurprisingly, more than 100 million Americans are in medical debt. Of those who appealed between 2019 and 2023, over 80 percent were approved, implying that the initial claims were valid. This game of attrition directly contradicts Medicare Advantage's promise to provide efficient, patient-centered healthcare. These denials are not just medically dangerous because they enable deadly diseases to progress unchecked. They are also emotionally erosive. Daily, we see patients shrink in the face of denials, unable to emotionally navigate the complex Medicare system and the immense pain, isolation and depression resulting from this behemoth that stands between their disease and their hope to be free of it. During one of Tom's chemo visits, with thousands of dollars worth of IVs in his veins, his skin pale and translucent, he realized he was begging his insurance at every turn to support him. Stories like Tom's reveal the truth: Medicare Advantage is unapologetically failing its elderly cancer patients. Sick American seniors deserve more than insurance coverage in name only. We advise our patients to avoid Medicare Advantage. The better choice is traditional Medicare, plus a secondary or supplemental insurance. Often, people do not enroll in supplemental insurance because they do not understand its importance, believe they will never get sick, miss the deadline for approval without a medical exam (you must do this within three months before or after your 65th birthday), or think it is too expensive. Although supplemental insurance costs nearly $500 a month (exact amounts vary based on age and income), choosing this add-on — and paying roughly $6,000 a year — is much more affordable than Medicare Advantage's yearly out-of-pocket (potentially adding up to $8,500) and fighting for approvals for basic treatment. On Medicare Advantage, Tom quickly reached his maximum yearly out-of-pocket of $8,500, but then it reset on Jan. 1. After four months of treatment, he was responsible for paying $17,000 for 16 months of care, on top of his insurance premiums, simply to receive standard care. Of course, if you are one of the fortunate few to have never experienced illness — and we hope you are — Medicare Advantage can be a cheaper option. The question is, how can we make Medicare Advantage advantageous for the vulnerable? There is a bipartisan opportunity to change the narrative around this insurance model. During his confirmation hearing as the head of the Centers for Medicare and Medicaid Services, Mehmet Oz criticized Medicare Advantage insurers for some of their practices. Strategic change — omitting out-of-pocket costs for cancer patients, curbing insurance companies' rights to deny claims submitted by doctors and speeding up the process — along with more rigorous oversight of the program are worthwhile goals the Trump administration and Congress should take on. While Democrats and Republicans disagree on many issues, we believe we can all agree that people like Tom — and the millions of other Americans enrolled in Medicare Advantage — deserve comprehensive and just care. Dr. Pramod Pinnamaneni, MD, MBA, and Dr. Nitya Thummalachetty, DrPH, are founders of the Nau Project, a start-up dedicated to helping everyday Americans navigate the complexities of our healthcare system. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
Yahoo
17 minutes ago
- Yahoo
How Trump's ‘big beautiful bill' could wreck Utah's groundbreaking AI laws
Utah Gov. Spencer Cox said President Donald Trump's 'big, beautiful' budget package could derail the state's groundbreaking artificial intelligence laws unless it is changed. The 1,000-page bill that passed the House last month includes a 10-year prohibition on AI regulations. An updated Senate version removed the all-out ban but conditioned $500 million in AI infrastructure grants on states pausing enforcement of AI laws. Behind these provisions is a desire by some lawmakers to prevent a nationwide patchwork of AI regulations that hampers innovation amid competition with China. But Cox, and Utah's top tech policymakers, said the approach taken by Trump's bill interferes with the state's right to react to rapidly evolving technologies. 'Our hope is that the last version of this bill that passes, whatever that looks like, will allow for the smart type of regulation that we're doing in Utah, and prevent the bad kind of regulation that would stop AI from reaching its fullest potential,' Cox said Tuesday during a monthly PBS broadcast. Utah has been recognized around the world for having the 'first and smartest of the AI regulations that have been proposed,' according to Cox. These policies include bills that create a state-run AI policy lab, clarify consumer protection liability for AI and require AI disclosures in industries like finance and mental health. The governor said that multiple members of the U.S. House have told his team that they were not aware of the AI moratorium when they voted on the bill. Members of the White House and Senate have also said that they don't want the 'BBB bill' to eliminate Utah's law, Cox said. 'AI companies actually support what we're doing because they recognize that this is the right way to do AI regulation as opposed to just piecemeal,' Cox said. Cox agreed that 'a hodgepodge' of AI laws around the country would cause the U.S. to 'fall behind and we would lose this global race that is happening right now.' But he said a moratorium on AI policy shouldn't come at the expense of Utah's novel approach which doesn't actually tell AI companies how they can develop their models. Utah Rep. Doug Fiefia, R-Herriman, said the problem goes beyond counterproductive policy. It targets the foundation of states rights that has allowed Utah to lead out on so many issues, according to Fiefia, a freshman lawmaker who previously worked at Google. 'States are laboratories for innovation when it comes to policy, and I believe that the federal government should not overreach on this process and allow it to work,' Fiefia said. 'We will not give over our control because the federal government believes that it's the right thing to do to win this race.' On Tuesday, Utah House legislative leadership, and 62 state senators and representatives, sent a letter authored by Fiefia to Utah's congressional delegation arguing that the moratorium hindered 'Utah's nationally recognized efforts to strike the right balance between innovation and consumer protection.' Not only would the moratorium harm state efforts to legislate guardrails, it would also hurt businesses that are using AI responsibly by allowing their competitors to engage in unethical behavior, according to Fiefia. States have shown they are more nimble than the federal government when they need to adapt to change, Fiefia said. And this is the approach Fiefia believes Utah has demonstrated in opening up legal pathways for innovation while updating the law for the threats posed by AI. 'Just because we want to move fast in this global arms race of AI doesn't mean we can't do so with a seat belt,' Fiefia said. 'I believe that we can both win this AI race, but also doing it in a thoughtful and meaningful way.' The AI moratorium faces procedural hurdles in addition to ideological pushback. Utah Sen. Kirk Cullimore, R-Sandy, pointed out that reconciliation bills are meant only to amend the annual budget and not make substantive policy shifts. Some senators have alleged that the AI moratorium does not comply with the 'Byrd Rule,' a procedural requirement that prohibits 'nonbudgetary' additions during the budget 'reconciliation' process. Cullimore, who was the sponsor behind most of Utah's AI legislation, was in Washington, D.C., last week, speaking with members of the House Commerce Committee, which oversaw the inclusion of the AI moratorium provisions. The intentions behind the moratorium, Cullimore said, were to prevent states from implementing what are called 'foundational regulations' that restrict the kind of technology AI companies can develop. Utah's laws do not do this, according to Cullimore, who also signed Fiefia's letter, but they would still be sidelined by the 'big beautiful bill' even if the moratorium is replaced by the conditioned federal funding. 'I think the drafting of the moratorium was so broad that it potentially encompassed all of that stuff,' he said. 'So I hope that that we can refine the text a little bit, and then if they want to put those conditions in on foundational regulation, I think that'd be appropriate.'
Yahoo
17 minutes ago
- Yahoo
Cramer: GOP has no ‘stomach' for Medicare changes in Trump megabill
Senate Republicans appear less likely to try to make changes to Medicare Advantage as part of their massive tax and spending bill, Sen. Kevin Cramer (R-N.D.) said Wednesday. Cramer raised the idea of targeting Medicare Advantage for additional savings last week after a closed-door caucus meeting, saying the program is ideal for reform because it is rife with waste, fraud and abuse. The House-passed bill would cut more than $800 billion from Medicaid and the Children's Health Insurance Program, but some GOP lawmakers argue that other mandatory spending programs, such as Medicare, should also be reviewed for 'waste' to further reduce the cost of the bill. But Medicare has long been considered a political third rail, and Cramer on Wednesday said he doesn't think Republicans want to try to go near it — even though Medicare Advantage changes have bipartisan support. 'I don't think there's a stomach for it. I think that the president doesn't want to touch Medicare,' Cramer said. When Republicans first floated the idea of Medicare changes last week, Senate Democrats jumped to open a new line of attack. Politically, it didn't matter that Republicans were discussing bipartisan legislation sponsored by Sens. Bill Cassidy (R-La.) and Jeff Merkley (D-Ore.) that would save billions of dollars by reducing overpayments to private Medicare Advantage plans. The legislation would crack down on a practice called 'upcoding' through which insurers classify patients as sicker so the government will reimburse them at a higher rate. Cramer noted it's difficult for members to try to talk about the changes. 'To be honest, I'm the only one I know that talks about it,' Cramer said. 'I just don't know how we get to where we want to get without going after some of the bigger drivers of the debt and deficit.' Senate Republicans will be briefed by Senate Finance Committee Chair Mike Crapo (R-Idaho) on Wednesday afternoon, ahead of the release of legislative text. Copyright 2025 Nexstar Media, Inc. All rights reserved. This material may not be published, broadcast, rewritten, or redistributed.
