The One, Big, Beautiful Bill Act cut health insurance subsidies starting this year, which impacted about 25,000 Alaskans. Enrollment in healthcare.gov declined by about 10% and other Alaskans are likely to lose Medicaid in the coming years due to new work requirements.
Having thousands more uninsured Alaskans can have serious financial consequences for individuals, families and the state. One main reason is that when people are uninsured they tend not to get care until it's a true emergency. Jared Kosin, who heads the Alaska Hospital and Health Care Association, said people often end up in the ER.
“That's the most expensive place to get health care in the entire health care system,” he said.
Emergency rooms have to provide medical care even if people can’t pay their bills, and ultimately that drives up health care costs for everyone.
So, I wanted to find out what kinds of options are available to Alaskans without insurance, especially for preventive care that could reduce high bills, heartache and trips to the ER.
Charity care and sliding scale
Experts like Kosin were hesitant to even talk about non-insurance options. He wants to find ways more Alaskans can afford coverage, but he suggested that if people are stressed about accessing care, they can reach out to their provider.
“Ask them directly if they have any suggestions, and see if they can come up with anything,” he said. “And I know in the hospitals, we have charity care programs.”
He said some doctors' offices also have charity programs. And some clinics offer free or sliding scale care, so call around for details on income cutoffs and requirements.
There are four other health insurance alternatives accessible for most Alaskans, some of which are newly allowed in the state
Non-insurance options
1. Health care sharing ministries. These are typically faith-based organizations where members share health care costs. But, as the Alaska Division of Insurance points out on their website, these organizations don’t have to follow health insurance regulations and there’s no legal requirement for them to cover the health costs of members. I couldn’t find any ministries based in Alaska, but there are some in the Lower 48 that serve the state.
2. Memberships with primary care provider clinics. “It covers their annual exams that they have, all their annual lab work, their annual flu shot, pneumonia vaccines, those kinds of things,” said Cindy Alkire at Arete Family Care in Anchorage, which offers a direct primary care membership. “And then we also allow three other visits per year, sick visits for things that are going on or chronic conditions.”
At Arete, plans are affordable compared to most health insurance. For adults under 45, it’s $125 a month and it’s $90 a month for kids, including childhood vaccines. There are several other clinics in Alaska offering memberships like this, but the plans typically don’t cover things like X-rays, hospital visits or some expensive medications.
3. Health discount plans. You may have heard of GoodRx which is a free prescription discount plan. But there are also paid discount plans for dental care, and vision, hearing aids, lab work and, less commonly, health care. They’re nothing like health insurance but they can make it cheaper to pay out-of-pocket. Several Alaska communities opted in to a discount card through the Alaska Municipal League–Kenai Peninsula, Fairbanks North Star and Mat-Su Boroughs.
A last safety net
4. And if the worst happens, there’s a safety-net program run by a nonprofit organization that can get people free care for complex medical needs.
Melinda Freemon, executive director of Anchorage Project Access, said, “We provide specialty medical, dental and mental health care that's provided for people who are unable to access this type of care through their primary care doctors.”
It’s free and includes complex care like cancer treatment or surgeries. It’s available to uninsured people or those awaiting enrollment for Medicaid, but it requires treatment in Anchorage and a health care provider referral, although people can refer themselves for dental care and mental health care programs.
