How much more are ALASKA ACA enrollees *really* paying this year due to Trump/GOP policies?

IMPORTANT: See the original post in this series for an explanation of the methodology.

Regular readers know that I've been obsessing over the massive increases in both gross as well as net premiums for ACA health insurance policy enrollees being caused by the combination of Congressional Republicans allowing the enhanced federal tax credits to expire as well as other Trump Regime policy changes for well over a year and a half now.

I've written countless analyses of how much both gross and net premiums skyrocketed from 2025 to 2026 across different states, different income levels and various other demographics...and last week it was revealed that over 3 million ACA exchange enrollees had already been priced out of the market as of April, with the number almost certain to climb further throughout the rest of 2026.

As I've repeatedly warned, however, the increases in premium costs (whether gross or net) are only half the story. The other big shoe which is dropping this year is increased out of pocket costs as millions of the ~19.2 million or so remaining enrollees as of April have been forced to downgrade their coverage to avoid (or at least minimize) those massive premium spikes.

In most cases this means moving to plans with higher deductibles, higher co-pays & higher coinsurance costs. In many cases this has also included moving to plasn with worse networks, referral requirements to see specialists and so on.

With that in mind, that's exactly what I've decided to set out to do: Calculate the average year over year increase not just in net premiums (that is, how much more ACA enrollees are having to pay each month) but also the year over year change in average out of pocket costs.

In the first post of this series, I focused on ALABAMA. Today I'm tackling ALASKA, but before I do, I need to make an important addition to the Alabama data.

This morning, healthcare policy/data firm KFF published a new analysis of actual 2026 ACA enrollment and determined that average ACA Marketplace deductibles actually increased by a whopping 37% (or $1,027 per person) to a record high of $3,786 in 2026...which only serves to underscore the entire point of the very out of pocket cost analysis project you're reading right now!

I've been able to utilize KFF's data to estimate the average deductible for every state in both 2025 & 2026 as well, and have decided to start adding to those to the graphs as shown below. In Alabama specifically, deductibles have shot up from ~$2,444 to ~$3,809 on average, a 56% hike.

(I'm also adding the combined percent increase in premiums + OOP costs while I'm at it...combined, Alabaman ACA enrollees are paying an average of around 73% more for healthcare this year than last year).

OK, moving back to ALASKA:

First, as I explained yesterday, here's total Open Enrollment plan selections for both 2025 & 2026 broken out by both metal level and Actuarial Value (AV) category. This allows me to calculate the weighted average AV for the entire populatoin, which dropped from 75.2% last year to 73.6% this year:

I should note that Alaska is (for obvious reasons) one of only a handful of states which has a significant ACA population eligible to take advantage of the ACA's special Cost Sharing Reduction assistance specifically intended for members of both federally-recognized American Indian tribes as well as Alaska Natives. In most states AI/AN CSR enrollees only make up a few tenths of a percentage of total ACA enrollees; in Alaska they made up over 5% of all enrollees in 2025 and over 6% this year.

I then used these numbers, combined with the average gross premiums per enrollee to calculate the average total medical expenses each enrollee racks up each year assuming an 80% average Medical Loss Ratio (which, as I stated yesterday, can vary widely by carrier and year, so this should be considered a very broad average only):

Alaska is also one of just two states which saw gross premiums drop overall this year, by 5.6% on average...not that this did much to help with the net premiums actually paid by the enrollees: Overall, the ~26,000 Alaskans who signed up during Open Enrollment (over 2,600 fewer than last year) saw their average net premiums skyrocket by over 54%.

The saving grace (of sorts) is that overall, Alaska enrollees were actually able to keep their average out of pocket costs nearly the same, only going up 2.5%. Combined with the premium spike, this means their total healthcare expenses jumped up by around 25% overall...from ~$6,200 to over $7,700 apiece.

On average, Alaska enrollees are paying over $1,500 more total this year than last.

Of course, for those who are outliers at the high end, average deductibles also jumped by 22%, and of course the maximum (theoretical) out of pocket cut-off for all ACA enrollees went up by over 15% this years as well, to $10,600 for sole coverage.

Next up: ARIZONA!​​