Alaska physicians are sworn to care for our community, protect our patients, and do no harm. Unfortunately, insurance companies and special interests take no such oath. This is why it is our duty to uphold the 80th percentile rule.
The 80th percentile rule is an important regulation to protect Alaska patients and consumers from predatory practices by insurance companies. It was accepted by the state due to the volume of complaints from Alaskans that their insurance companies were not paying their medical bills and that Alaskans had paid more than promised on their health insurance policies. It is designed to ensure that insurance companies located outside of Alaska will not pay only a portion of your medical bills and pass the rest on to the patient. It protects Alaskans from insurance companies and, more importantly, the 80th percentile rule works. Multiple states have similar laws, regulations or rules; We are hardly the first or the only. The new federal No Surprises Act, claimed by insurance companies as a reason to drop the 80th percentile rule, provides some protections only for emergency services — it does not replace the 80th percentile rule — and has been plagued by lawsuits across the country.
Physician groups are both care providers and employers that offer insurance benefits to employees. They, like other Alaskans, have reported significant increases in premium rates over the years — even during the COVID-19 pandemic, when insurance companies recorded record profits. Premera, the state’s largest insurer based out of state, was recently forced to return millions of dollars to Alaska after making more profits than legally allowed. Any of these would have had the opportunity to reduce the financial burden of health care costs that insurers and special interests are blaming on physicians, but instead they have focused on repealing the 80th percentile rule to extract more money from our states. Moreover, they do so while citing decades-old data and refusing to provide transparency by participating in statewide all payer claims databases.
Repealing the 80th percentile rule would destroy our health care system and hurt Alaskans. Unlike the 1970s and 1980s, we now enjoy a robust health care system where Alaskans no longer have to travel to the Lower 48 for routine or specialty care. Health care is a major employer for Alaskans and supports Alaska’s economy by providing well-paying jobs with good benefits. Without the 80th percentile rule, our community will lose jobs and local access to health care, which will especially harm those who live rurally, have no means of travel, or cannot travel due to illness or infirmity. Removing the 80th percentile rule and shrinking our health care system would have many unintended consequences, including reducing access for the elderly, Medicare and Medicaid beneficiaries, and vulnerable populations. It is our 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 predatory insurance practices.
It is the duty and responsibility of the government to protect citizens from harm. Protecting the 80th percentile rule protects those of us who live and work in Alaska. It is irresponsible and dangerous to dismiss the 80th percentile rule based on an advertising campaign sponsored by special interests in the hope that an increase in insurance company profits will result in a slight decrease in your insurance premiums.
Jessica Panko, MD, President of the Alaska State Medical Association.
The opinions expressed here are those of the author and are not necessarily endorsed by the Anchorage Daily News, which welcomes a wide range of viewpoints. To submit a piece for consideration, email Commentary (at)adn.com. Send submissions shorter than 200 words [email protected] or Click here to submit via any web browser. Read our full guidelines for letters and comments here.