Medicaid in Alaska
Alaska expanded Medicaid in September 2015, making it one of the later expansion states. Governor Bill Walker used executive authority to accept the expansion after the state legislature failed to act. The expansion covers adults aged 19 to 64 earning up to 138% of the federal poverty level (about $27,531 for a single person, using the Alaska guidelines that apply to 2027 coverage).
Before expansion, Alaska had one of the highest uninsured rates in the country at about 18%. The expansion brought coverage to more than 80,000 previously uninsured Alaskans, and the uninsured rate dropped to roughly 11%. That is still above the national average, partly because of Alaska's transient workforce in industries like fishing, oil, and seasonal tourism.
Alaska's Medicaid program is administered by the Department of Health. Enrollment is year-round for Medicaid (no open enrollment period required). If your income falls below 138% FPL, Medicaid is almost certainly a better option than a marketplace plan.
What plans cost in 2027
Alaska consistently has the highest ACA marketplace premiums in the nation, and 2027 brings another large increase. Based on HealthCare.gov plan data, the benchmark Silver plan for a 40-year-old in Anchorage costs about $1,299 per month before subsidies in 2027, up from about $1,024 in 2026, an increase of roughly 27%. Fairbanks is about the same, and Juneau is somewhat lower at about $1,164. The reasons are familiar: a small risk pool, high healthcare costs, expensive medical transport (air ambulance is common in remote areas), and very little insurer competition.
High benchmark premiums mean larger subsidies for those who qualify, because the premium tax credit is pegged to the benchmark plan. A person earning $30,000 per year might pay very little for a Silver plan after the credit is applied. The catch is the subsidy cliff. The enhanced premium tax credits expired after 2025 and were not extended, so for 2027 people above 400% FPL (about $79,800 for an individual in Alaska) get no subsidy and pay the full sticker price.
Alaska had approximately 18,000 marketplace enrollees for 2025. The small enrollment is partly because Medicaid expansion absorbed many lower-income residents, and many working Alaskans get coverage through large employers in oil, government, and military sectors.
Carriers in Alaska (2027)
Two insurers offer individual marketplace plans in Alaska for 2027, and both are available statewide:
- Premera Blue Cross Blue Shield of Alaska is the larger of the two and covers most marketplace enrollees. Premera offers plans across the metal tiers. Their network includes Providence Alaska Medical Center in Anchorage, Fairbanks Memorial Hospital, and most major facilities in the state. For specialty care that requires travel to Seattle or other Lower 48 cities, Premera generally covers out-of-state providers within their broader Blue Cross network.
- Moda Healthis the second marketplace carrier. Moda offers a smaller set of plans, and its network differs from Premera's, so check that your doctors and nearest hospital are included before switching. With Premera's prices rising sharply for 2027, it is worth comparing both carriers' plans side by side.
Two carriers is still very little competition. Alaska runs an individual market reinsurance program (the Alaska Reinsurance Program) under a federal 1332 waiver that helps stabilize premiums, but the fundamental cost drivers remain.
Key regions
Anchorage
About 40% of Alaska's population lives in the Anchorage metro area. Providence Alaska Medical Center is the state's largest hospital and primary trauma center. Alaska Regional Hospital is the other major Anchorage facility. Most specialists in the state practice in Anchorage, making it the hub for complex care. If you live elsewhere in Alaska, there is a good chance you will travel to Anchorage for anything beyond basic care.
Fairbanks and the Interior
Fairbanks Memorial Hospital serves Interior Alaska. The Fairbanks area has a smaller provider network, and some specialty services require travel to Anchorage. Winter conditions can complicate medical transport, so check how each plan covers medevac services before you enroll.
Juneau and Southeast Alaska
Bartlett Regional Hospital in Juneau is the primary facility for Southeast Alaska. Many communities in this region are accessible only by air or ferry. Residents in smaller towns like Sitka, Ketchikan, and Wrangell often travel to Juneau, Anchorage, or Seattle for specialized treatment. Telehealth has expanded significantly in Southeast Alaska and can reduce the need for some travel.
Rural and remote Alaska
Much of Alaska is served by tribal health organizations and community health centers rather than traditional hospitals. The Alaska Native Tribal Health Consortium (ANTHC) and Southcentral Foundation operate the Alaska Native Medical Center in Anchorage. Alaska Natives and American Indians may also access care through Indian Health Service facilities. For non-Native rural residents, the nearest hospital can be hundreds of miles away, making insurance with air ambulance coverage particularly important.
Estimate your subsidy
Subsidy Estimator
Enter your info below to get a rough estimate of your monthly premium tax credit for a 2027 marketplace plan.
Alaska-specific things to know
Alaska's poverty guidelines are higher. Alaska and Hawaii have separate federal poverty level guidelines that are higher than the 48 contiguous states. For 2027 coverage, 100% FPL for a single person in Alaska is $19,950 (compared to $15,960 in most states), plus $7,100 for each additional household member. This means the income thresholds for Medicaid and marketplace subsidies are correspondingly higher.
The reinsurance program matters.Alaska's 1332 waiver reinsurance program covers a share of high-cost claims, which keeps premiums lower than they would otherwise be. It is funded through a combination of state funds and federal pass-through savings.
Check tribal health options. If you are Alaska Native or American Indian, you have additional enrollment options and cost protections. Members of federally recognized tribes can get special cost-sharing protections, and you can enroll or change plans once a month (not just during open enrollment).
Open Enrollment dates. Open Enrollment for 2027 runs from November 1, 2026, through January 15, 2027, on HealthCare.gov. Enroll by December 15 for coverage that starts January 1, or between December 16 and January 15 for coverage that starts February 1.
Resources
- HealthCare.gov for marketplace enrollment (Alaska uses the federal marketplace)
- Alaska Department of Health — Medicaid for Medicaid eligibility and enrollment
- Premera Blue Cross Blue Shield of Alaska for plan details and provider directories