Alaska’s eightieth percentile rule protects sufferers

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Alaska physicians have taken an oath to take care of our communities, defend our sufferers and do no hurt. Sadly, insurance coverage firms and particular pursuits take no such oath. Because of this it’s our obligation to make sure the eightieth percentile rule is preserved.

The eightieth percentile rule is a vital regulation to guard Alaska sufferers and shoppers from predatory practices by insurance coverage firms. It was adopted by the state because of the quantity of complaints from Alaskans that their insurance coverage firm was not paying their medical payments and Alaskans have been left paying greater than their medical insurance coverage promised. It was designed to make sure insurance coverage firms based mostly exterior of Alaska don’t pay solely a part of your medical invoice and saddle the affected person with the rest. It protects Alaskans from insurance coverage firms and, extra importantly, the eightieth percentile rule works. A number of states have comparable legal guidelines, laws or guidelines; we’re hardly the primary or the one. The brand new federal No Surprises Act, touted by insurance coverage firms as a motive to remove the eightieth percentile rule, solely supplies some safety for emergency companies –it doesn’t substitute the eightieth percentile rule — and is mired in litigation throughout the nation.

Doctor teams are each suppliers of care and employers who present insurance coverage advantages to workers. They report important will increase in premium charges for years like all different Alaskans — even in the course of the COVID-19 pandemic, when insurance coverage firms recorded file earnings. Premera, the state’s largest insurer, which is predicated out of state, has just lately been compelled to present tens of thousands and thousands of {dollars} again to Alaska as a consequence of making extra earnings than is legally allowed. Any of those would have been alternatives to lower the monetary burdens of well being care prices that insurers and particular pursuits are blaming on physicians, however as a substitute they’ve targeted on repealing the eightieth percentile rule to extract much more cash from our state. Furthermore, they do that whereas citing decades-old information and refusing to supply transparency by taking part in a statewide All Payer Claims database.

Repealing the eightieth Percentile Rule would decimate our healthcare system and hurt Alaskans. In contrast to the Nineteen Seventies and Nineteen Eighties, we now get pleasure from a strong healthcare system the place Alaskans not have to journey to the Decrease 48 for routine or specialty care. Well being care is a significant employer for Alaskans and supplies well-paying jobs with good advantages, supporting the Alaska financial system. With out the eightieth percentile rule, our neighborhood would lose jobs and native entry to well being care, which is able to particularly hurt those that dwell rurally, don’t have the means to journey, or can not journey as a consequence of sickness or frailty. Eradicating the eightieth percentile rule and shrinking our healthcare system could have many unintended penalties, together with decreasing entry for seniors, Medicare and Medicaid beneficiaries, and weak populations. We have now an ethical obligation to oppose repealing the eightieth percentile rule.

Make no mistake: The eightieth percentile rule is for client safety, and it protects Alaskans from predatory insurance coverage practices.

The federal government has an obligation and duty to guard its residents from hurt. Preserving the eightieth percentile rule protects these of us who dwell and work in Alaska. Repealing the eightieth percentile rule based mostly on an promoting marketing campaign sponsored by particular pursuits within the hopes that rising insurance coverage firm earnings might trickle right down to a tiny lower in your insurance coverage premium is irresponsible and harmful.

Jessica Panko, MD, is president of the Alaska State Medical Affiliation.

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