Alaska Legislature approves subscription health care bill

The Alaska Legislature has adopted a bill that would legalize subscription-based health care in the state.

The bill would allow primary care providers to offer care to patients based on a monthly fee, similar to a gym membership. Direct health agreements, as they are called, can give patients access to limited health care services without the involvement of insurance companies.

The Senate voted Thursday in a 12-7 split to adopt changes made to the bill by the House. The bill is the fifth measure adopted by the full Legislature this year. It heads next to Gov. Mike Dunleavy. His spokesperson did not say Thursday whether the governor intended to sign the bill.

The proposal has long been supported by conservative groups, including the Alaska Policy Forum, that argue it could reduce the cost of health care in Alaska.

Some lawmakers expressed reservations about the concept of subscription-based health care, saying it could improve options for Alaskans willing to pay for a subscription on top of their insurance policy — while doing nothing to improve access for Alaskans who are unable to afford insurance or whose insurance policies provide only limited coverage for routine care.

The bill includes a provision requiring clinics that offer such agreements to continue accepting Medicare patients, and have at least 20% of their patients be insured through Medicare or entirely uninsured. The provision is meant to help address a longstanding shortage of providers willing to accept patients who rely on public insurance policies.

The Senate had approved a previous version of the bill in May with 18 senators in support, but House members had amended the measure earlier this month to remove some of the restrictions favored by the Senate.

Among the restrictions removed by the House was a requirement that the clinics offering direct health agreements be owned by Alaska-based providers, in an effort to stave off the purchase of the clinics by private equity firms that could reduce the quality of care. Another change made by the House was the removal of a requirement that clinics providing such agreements clearly articulate to their patients that the agreements are not a form of insurance — meaning that more expensive or complex forms of care would not be covered or provided.

“Alaskans don’t get to know what they’re buying isn’t insurance,” said Sen. Jesse Kiehl, D-Anchorage, who voted against the bill Thursday. “If you believe you have something you don’t have, you and your family are left exposed.”