Overview
According to data from the Council for Community and Economic Research, health services in Alaska are 70 – 200 percent more expensive than the national average. Many pressures influence Alaska’s health-care costs. They include expenses related to recruiting providers from out of state, lack of competition, the state’s small population.
In 2016, Alaska passed a law which set up a $55 million fund for the Alaska Reinsurance Program (ARP), financed through an existing tax on all insurance companies, to subsidize enrollees’ costs as the state struggles with Obamacare price spikes. Alaska Governor Bill Walker said the program would ensure that the 23,000 Alaskans enrolled in exchange plans would not suddenly lose their insurance. The state also received CMS approval for federal passthrough to partially finance the ARP, which would fully or partially reimburse insurers for incurred claims for high-risk enrollees diagnosed with certain health conditions.
In recent legislative terms, Alaska sought legislative solutions to skyrocketing healthcare costs in terms of price transparency and cost containment. Most notably, the legislature made repeated attempts to establish an all-payer claims database (APCD). The legislature also continued to introduced bills that would create a shared savings incentive program that encourages patients to become active consumers and to actively shop for the most competitive prices for care. Other price transparency measures propose to limit how much an insurance company must reimburse an out-of-network provider for covered services and would require providers and medical facilities to disclose the undiscounted costs of their most common procedures.
In 2024, the Alaska Legislature considered legislation to repeal the state’s certificate of need program, establish a healthcare provider tax, and to address pharmacy benefit manager issues.
State Action
Latest Legislative Session: 1/17/2023 - 4/17/2022 (2023-2024 term). *Current session bill updates are ongoing. Check back weekly for updates.
HB 16 – Alaska
Introduced: 2023 Status: In Process
An Act requiring the state medical assistance program to provide certain services; relating to cost containment measures for the state medical assistance program; relating to payment for adult dental services; and providing for an effective …
HB 176 – Alaska
Introduced: 2021 Status: Inactive / Dead
An Act relating to insurance; relating to direct health care agreements; and relating to unfair trade practices.
HB 187 – Alaska
Introduced: 2023 Status: In Process
An Act relating to utilization review entities; exempting certain health care providers from making preauthorization requests for certain services; and providing for an effective date.
HB 226 – Alaska
Introduced: 2024 Status: In Process
An Act relating to the Board of Pharmacy; relating to insurance; relating to pharmacies; relating to pharmacists; relating to pharmacy benefits managers; relating to patient choice of pharmacy; and providing for an effective date.
HB 229 (see companion bill SB 201) – Alaska
Introduced: 2020 Status: Inactive / Dead
An Act establishing the Alaska Health Care Transformation Corporation; relating to an all-payer claims database; and providing for an effective date.
Alaska Stat. § 18.09.010. Alaska Health Care Commission: Alaska Health Care Commission – Alaska
Introduced: Status: Enacted
Creates the Alaska Health Care Commission to serve as the state health planning and coordinating body, with duties to reduce health care costs by enhancing market forces and increase saving from health information technology, among …
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Alaska Stat. § 18.09.070. Duties of the commission: Alaska Health Care Commission – Alaska
Introduced: Status: Enacted
The commission shall serve as the state health planning and coordinating body. Consistent with state and federal law, the commission shall provide recommendations for and foster the development of a statewide health plan
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Alaska Stat. § 18.23.300. Creation of health information exchange system: Electronic Health Information Exchange System – Alaska
Introduced: Status: Enacted
Creates a statewide electronic health information exchange system in order to “promotes a more effective marketplace, greater competition, greater systems analysis, increased choice, enhanced quality, and improved outcomes in health care services.”
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Alaska Stat. § 18.23.305. Department; duties: Electronic Health Information Exchange System – Alaska
Introduced: Status: Enacted
In carrying out its duties under AS 18.23.300, the department shall do the following.
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Alaska Stat. § 18.23.325. Definitions: Electronic Health Information Exchange System – Alaska
Introduced: Status: Enacted
Definitions of Alaska’s Electronic Health Information Exchange System
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In re: Suboxone Antitrust Litigation (State of Wisconsin, et al. v. Indivior Inc, et al.) – Alabama, Alaska, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Georgia, Hawaii, Idaho, Illinois, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Nebraska, New Hampshire, New Mexico, New York, North Carolina, Ohio, Oklahoma, Oregon, Pennsylvania, South Dakota, Tennessee, Utah, Virginia, Washington, West Virginia, Wisconsin
District Court: E.D. Pennsylvania Status: Pending
In September 2016, 35 state attorneys general and the District of Columbia brought a multi-district case against pharmaceutical manufacturer Indivior, MonoSol RX et al., alleging …
In Re: Generic Pharmaceuticals Pricing Antitrust Litigation – Alabama, Alaska, Arizona, Arkansas, California, Colorado, Connecticut, Delaware, District of Columbia, Florida, Hawaii, Idaho, Illinois, Indiana, Iowa, Kansas, Kentucky, Louisiana, Maine, Maryland, Massachusetts, Michigan, Minnesota, Mississippi, Missouri, Montana, Nebraska, Nevada, New Hampshire, New Jersey, New Mexico, New York, North Carolina, North Dakota, Ohio, Oklahoma, Oregon, Pennsylvania, South Carolina, Tennessee, Utah, Vermont, Virginia, Washington, West Virginia, Wisconsin
District Court: Eastern District of Pennsylvania Status: Pending
Plaintiffs are attorney generals from 48 states, Puerto Rico, and the District of Columbia, as well as classes of private plaintiffs that filed an antitrust …
Additional Resources
STATE BUDGET
Alaska operates on an annual budget cycle, with the fiscal year beginning July 1 and ending June 30. Agencies submit their budget requests to the Governor in October, with the Governor submitting their proposed budget to the state legislature by December 15. The legislature adopts a budget by a simple majority in April. The governor is required to submit a balanced budget, and the legislature is required to pass a balanced budget
STATE LEGISLATURE
The 40 members of the House of Representatives serve two year terms, and the 20 Senators serve four year terms, staggered so half stand for election every two years. The 60 member combined legislature is the smallest bicameral state legislature in the US.
Annual sessions begin in January and are limited by statute to 90 calendar days. Special sessions of 30 calendar days may be convened by a consensus of two-thirds of each chamber. Bills carry over from odd to even numbered years.