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Alaskan doctors take an oath to care for our communities, protect our patients, and do no harm. Unfortunately, insurance companies and special interests do not take such an oath. This is why it is our duty to ensure that the 80th percentile rule is maintained.
The 80 percent rule is an important regulation for protecting Alaskan patients and consumers from unfair insurance company practices. It was adopted by the state due to the volume of complaints from Alaskans that their insurance company was not paying their medical bills and letting Alaskans pay more than the health insurance policy promised. It is designed to ensure that insurance companies based outside of Alaska only pay a portion of your medical bill and pass the rest on to the patient. It protects Alaskans from insurance companies, and most importantly, the 80 percent rule works. Multiple states have similar laws, regulations, or rules; We are hardly the first or the only. The new federal no-surprises law, which insurers are touting as a reason to repeal the 80th percentile rule, only provides some protection for emergency services—it doesn’t replace the 80th percentile rule—and it’s mired in litigation across the country.
Physician groups are both providers of care and employers who offer insurance benefits to employees. Like all other Alaskans, they’ve reported large increases in premium rates for years—even during the COVID-19 pandemic, when insurance companies reported record profits. Primera, the state’s largest insurer, which is headquartered out of state, was recently forced to return tens of millions of dollars to Alaska for making more profits than legally allowed. Any of these could have been opportunities to reduce the financial burden of health care costs that insurance companies and special interests blame on physicians, but instead they have focused on eliminating the 80 percent rule to extract more money from our state. What’s more, they do so while citing decades-old data and refusing to provide transparency by participating in the statewide All Payment Claims database.
Repeal of the 80th percentile rule will destroy our health care system and harm Alaskans. Unlike the 70’s and 80’s, we now have a robust health care system where Alaskans no longer need to travel to the Lower 48 for routine care or specialized care. Health care is a major employer in Alaska and provides well-paying jobs with good benefits, supporting Alaska’s economy. Without the 80th percentile rule, our society will lose jobs and local access to health care, which will especially hurt those who live in rural areas, don’t have the means to travel, or are unable to travel because of illness or weakness. Removing the 80th percentile rule and shrinking our health care system will have many unintended consequences, including limiting access for seniors, Medicare beneficiaries, Medicare, and vulnerable populations. We have a moral duty to oppose the abolition of the 80th percentile rule.
Make no mistake: The 80th percentile rule is for consumer protection, and it protects Alaskans from unfair insurance practices.
The government has a duty and responsibility to protect its citizens from harm. Maintaining the 80th percentile rule protects those who live and work in Alaska from us. Eliminating the 80 percent rule that is based on a special-interest sponsored advertising campaign hoping that the insurance company’s increased profits will flow into a slight drop in your premium is both irresponsible and dangerous.
Jessica Panko, MD, He is the President of the Alaska State Medical Association.
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