Alaska insurance sign-ups open with higher costs

Anchorage residents began shopping for health insurance on Sunday for the 2027 plan year. The open enrollment period for the Affordable Care Act marketplace, commonly called Obamacare, runs through Jan. 15. People who sign up this year should expect to pay more and find fewer choices than they did last year. The average price for a marketplace plan is projected to climb by 13 percent in 2027, according to new data analysis from the Kaiser Family Foundation, a healthcare research nonprofit.

The sign-up window started Sunday in Alaska and most other states. The marketplace, also known as the exchange, is where individuals and families buy private health coverage with federal help. The 2027 cycle brings several structural changes. Financial assistance, specifically premium tax credits and cost-sharing reductions, is now limited for many groups of people who previously qualified. Stricter enrollment checks and new restrictions for lawfully present immigrants also take effect this year.

Healthcare experts attribute the price hikes to rising medical costs and increased hospital market concentration. Cynthia Cox, a vice president and director of the ACA program at the Kaiser Family Foundation, cited the No Surprises Act and the growing availability of GLP-1 drugs as additional factors driving rates up. She noted that the people hit hardest by these changes are those who do not qualify for a subsidy.

"They may or may not be able to afford to continue to keep their coverage into next year," Cox said. She added that many of these individuals have already moved into bronze plans, which are the cheapest options available on the marketplace. A fact sheet distributed by the Centers for Medicare & Medicaid Services on Friday stated that Americans using HealthCare.gov will have access to low-cost plans.

The cost of ACA insurance has risen sharply during the current administration. Republicans opposed extending the pandemic-era subsidies that had kept costs down for most enrollees under former President Joe Biden. The loss of those enhanced subsidies led to 1.2 million fewer people signing up for coverage in the exchanges. As of February, roughly 19.2 million people in the United States were actively enrolled in ACA marketplace health plans, according to the Department of Health and Human Services.

New regulations starting in 2027 will limit tax credits for certain lawfully present immigrants. This change could result in an additional 1 million uninsured individuals over time. The administration has also been removing enrollees from the program as part of a campaign against waste, fraud, and abuse. In September, Vice President JD Vance and other officials announced plans to remove 760,000 ACA enrollees from public healthcare exchanges. They alleged these individuals were fraudulently enrolled or did not exist. Vance said the discovery and canceled subsidy payments would result in $2.2 billion in cost savings.

It is unclear how many more people will drop off of ACA coverage in 2027. Cox said that with higher premiums, immigration eligibility changes, and the ongoing anti-fraud efforts, there will likely be fewer people enrolled in this market. She added that it will be harder to understand exactly why the numbers drop.