Alaska

via the Centers for Medicare & Medicaid Services (CMS):

February 23: CMS approved a postpartum coverage extension state plan amendment (SPA) for Alaska (link to come). This SPA approval will extend comprehensive coverage after pregnancy through Medicaid and the Children’s Health Insurance Program (CHIP) for a full 12 months. The approval of Alaska’s SPA marks critical progress in implementing the CMS Maternity Care Action Plan, which supports the Biden-Harris Administration’s Maternal Health Blueprint, a comprehensive strategy aimed at improving maternal health, particularly in underserved communities. Alaska is the 44th state, including D.C. and the U.S. Virgin Islands that have extended postpartum Medicaid coverage to a full year, made possible by President Biden’s American Rescue Plan (ARP), and made permanent by the Consolidated Appropriations Act, 2023 (CAA, 2023), which President Biden signed into law in December 2022.

Originally posted 8/07/23; updated 11/02/03

Alaska is a sparsely populated state with only two carriers on their individual market and four on their small group market. Alaska's insurance department website is useless when it comes to getting rate filings or enrollment data; I had to use the federal Rate Review site to even get the requested rate changes.

Fortunately, Premera Blue Cross includes a summary which lists their enrollment numbers, and with Moda being the only other carrier on the market, I was able to estimate a weighted average (assuming Moda has around 4,000 enrollees, which seems about right given Alaska's total on-exchange enrollment of roughly 25,500 people during Open Enrollment; effectuated enrollment as of last spring is almost certainly a couple thousand lower overall).

From Premera's summary:

Alaska

Alaska is also a sparsely populated state with only two carriers on their individual market and four on their small group market. Alaska's insurance department website is useless when it comes to getting rate filings or enrollment data; I had to use the federal Rate Review site to even get the requested rate changes.

Fortunately, Premera Blue Cross includes a summary which lists their enrollment numbers, and with Moda being the only other carrier on the market, I was able to estimate a weighted average (assuming Moda only has around 2,200 enrollees, which seems about right given Alaska's total on-exchange enrollment of roughly 23,000 people).

Back in July, the preliminary 2023 rate filings averaged out at an ugly 18.7% between the two.

However, the final/approved rate filings for 2023 are out now that we're into the Open Enrollment Period, and while Premera saw a slight reduction in their rate hike, Moda's are jumping from a 4% increase to a whopping 12.1%. Wow.

Alaska

Alaska is also a sparsely populated state with only two carriers on their individual market and four on their small group market. Alaska's insurance department website is useless when it comes to getting rate filings or enrollment data; I had to use the federal Rate Review site to even get the requested rate changes.

Fortunately, Premera Blue Cross includes a summary which lists their enrollment numbers, and with Moda being the only other carrier on the market, I was able to estimate a weighted average (assuming Moda only has around 2,200 enrollees, which seems about right given Alaska's total on-exchange enrollment of roughly 23,000 people).

Average rate change for unsubsidized enrollees in 2022 will be an ugly 18.7% on the individual market...underscoring how vitally important it is that the American Rescue Plan subsidies be extended (preferably permanently).

On the small group market, the unweighted average increase is 4.8%.

Rate Changes

As I noted last night, thanks to the federal Rate Review website finally being updated to include the final, approved 2022 rates for both the individual and small group markets in all 50 states (+DC), I've been able to fill in the missing data for my annual ACA Rate Change Project.

As I note there, the overall weighted average looks like it'll be roughly +3.5% nationally.

Normally I write up a separate entry for both the preliminary and approved rate changes in each individual state, but it seems like overkill to create 14 separate entries at once. Besides, in many of these states there's been few if any changes between the preliminary and approved rate changes.

Alaska

Like Wyoming, Alaska is also a sparsely populated state with only two carriers on their individual market and three (possibly four?) on their small group market. Also like Wyoming, Alaska's insurance department website is useless when it comes to getting rate filings or enrollment data; I had to use the federal Rate Review site to even get the requested rate changes.

Fortunately, Premera Blue Cross includes a summary which lists their enrollment numbers, and with Moda being the only other carrier on the market, I was able to estimate a weighted average (assuming Moda only has around 2,000 enrollees, which seems about right given Alaska's total on-exchange enrollment of roughly 18,000 people).

On the small group market, only three carriers are listed in the federal database; Premera Blue Cross isn't, which either means they're pulling out of the state's small biz market or they just haven't been added to the database yet.

Average rate change for unsubsidized enrollees in 2022 will be 10.6% on the individual market...except that almost every enrollee will qualify for financial subsidies this year. On the small group market, the unweighted average increase is 6.4%.

Alaska

IMPORTANT UPDATE: It turns out I had Alaska's "boroughs" and "census areas" (not counties) completely botched in several ways. On top of having some names/populations wrong, it also turns out that one of the "census areas" doesn't even exist anymore...it was abolished and split into two new census areas.

The entire post and graphs below have been updated/corrected to reflect this.

UPDATE 6/03/21: I've updated the graphs and table below and am not using fully-vaccinated residents only in order to make Alaska consistent with every other state.

It's also worth noting that the CDC says around 2.9% of all fully vaccinated AK residents (7,900 people) have an unknown home borough/area.

Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.

Here's Alaska.

Alaska Icon

As I noted recently, I've relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For total monthly Medicaid enrollment, the official Medicaid.gov monthly enrollment data is only available dating back to late 2013, and it's only current through November 2020. The Kaiser Family Foundation has also compiled the pre-2014 average enrollment for each state based on the 3rd quarter of 2013. In some states I've been able to find more recent enrollment data for December 2020 or later.

Over at Xpostfactoid, my colleague Andrew Sprung has been doing a great job of tracking ACA Medicaid expansion enrollment growth since the onset of the COVID-19 pandemic this past February/March at the macro (national) level, by looking at around a dozen states which have monthly reports available. He puts the overall enrollment growth rate at 23.6% from February thorugh October 2020.

Instead of replicating his work, I decided to take a closer look at individual states. The graph below shows how many Alaskans have been actively enrolled in our Medicaid expansion program (Healthy Michigan) every month since it was launched in September 2015:

Unfortunately, Alaska's 2021 rate filings aren't available via the state insurance department website or the SERFF database, and the actuarial memos posted to the federal Rate Review database are heavily redacted, so I can't run a weighted average rate change for either the individual or small group market.

The unweighted average changes, however, are a 2.0% reduction on the indy market and a 1.9% reduction for small group plans.

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