An Alaska judge is backing the state’s decision to repeal a longstanding rule that was meant to keep down health care costs in the state.
Under the 80th percentile rule, which was repealed by the administration of Gov. Mike Dunleavy in January 2024, insurance companies were required to pay out-of-network providers at least the 80th percentile of the average going rate for a medical service.
The rule prevented Alaska patients from receiving large medical bills for out-of-network care. But the Dunleavy administration and the state’s biggest insurance company, Premera Blue Cross Blue Shield of Alaska, argued the rule also increased the cost of health care over time.
The repeal was broadly opposed by dozens of health care providers across the state, who said the removal of the rule will make it harder for them to stay afloat while benefiting insurance companies that are headquartered in the Lower 48.
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If insurance companies significantly lower their reimbursement rates, providers said, keeping their doors open may no longer pencil out.
A coalition of providers sued in late 2023 to keep the rule in place, arguing that the Division of Insurance had not sufficiently proven that the rule was responsible for increases in the cost of health care in Alaska.
The case went to trial in February. Late last month, Anchorage Superior Court Judge Yvonne Lamoureux ruled in favor of the state.
“The evidence at trial established the Division (of Insurance) did not make the repeal decision lightly,” Lamoureux wrote in her ruling, concluding that the repeal was “not unreasonable or arbitrary.”
In a statement, Dr. John Morris, an anesthesiologist who spearheaded the lawsuit on behalf of the health care providers, said the coalition is “disappointed with the ruling.”
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“Each year insurers pay physicians and healthcare providers less for the same care but somehow also blame doctors for rising health insurance costs,” Morris said. “We remain committed to bringing health care costs down while making sure our seniors and veterans have a doctor to see. This ruling doesn’t help.”
The Division of Insurance had considered repealing the rule for over a decade as part of its efforts to address rising health care costs in Alaska. Premera, an insurance company that controls a large share of Alaska’s individual insurance market, was strongly in favor of the repeal.
Former Division of Insurance Director Lori Wing-Heier previously indicated that repealing the rule would lead to a reduction in Premera’s premium rates by between 2% and 3%.
In reality, rates are set to remain largely unchanged next year, after massive increases in the preceding three years, according to Premera’s federal filings. Premera executives contend that premiums would have gone up substantially next year had the rule remained in place.
At stake in the lawsuit was the question: What is driving the sky-high cost of health care in Alaska? Premera and the state contended that the answer, in part, was that Alaska’s health care providers were charging ever-higher prices because of the 80th percentile rule, thus driving up costs for consumers. Health care providers said that it is insurance companies like Premera that are driving up costs while providers themselves struggle to afford to keep their doors open.
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A study from the Medical Group Management Association released last year found that primary care providers in Alaska are the lowest-paid in the country. Advanced specialists, meanwhile, are among the highest paid, the study found.
Court filings indicated that Premera did, in fact, save millions of dollars in 2024, after the rule was repealed. But it was not immediately clear whether the savings for the insurance company were passed along to consumers through lower health care bills.
The end result of the repeal of the rule may be that more Alaska providers join and remain in-network with Premera and other large insurance companies. In 2024, 1,000 providers moved in-network in Alaska, according to testimony from Wing-Heier. No providers reported to the Division of Insurance needing to close their doors due to the repeal, Wing-Heier testified.
The first Jesuit missionaries in Alaska sailed up the Yukon River in 1887. By the turn of the 20th century, the religious order of the Catholic Church had as many as 50 Jesuits in the state.
Now, only two remain. And by the end of June, there will be none.
The Jesuits’ nearly 140 years in the state was honored at an event at Bethel’s Immaculate Conception Church on June 16. A procession of priests wearing long white gowns with red hems walked down the aisle to open the event. The Bishop of the Diocese of Fairbanks, Stephen Maekawa, thumped the ground with a shimmering silver staff known as a clozier as he approached the altar.
Bishop of the Diocese of Fairbanks, Steven Maekawa, walks toward the altar at the Immaculate Conception Church in Bethel.
“My brothers and sisters, we gather together to celebrate this wonderful and blessed occasion to acknowledge the love of God and the work of God through the 139 year mission of the Society of Jesus of the Jesuit fathers,” Maekawa said to open the event.
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A traditional Catholic mass followed, with readings in both English and Yup’ik. During the sermon, Maekawa acknowledged the vastness of the Fairbanks diocese, and the tremendous amount of work done by the Jesuits to establish it.
“All of the 46 churches of the Diocese of Fairbanks that we currently have were established by either the Jesuit fathers or by direction of a Jesuit bishop,” Maekawa said. “We have a long history of the Society of Jesus’ presence and ministry here in all of Alaska.”
The Jesuits are an order within the Catholic Church, akin to the Dominicans or Franciscans. They have a reputation for taking on some of the Catholic Church’s most remote assignments.
That missionary spirit brought the Jesuits to the Yukon River in 1887, where they built churches, schools, and ministries. Without their work, Catholicism may not have taken root in huge swaths of Alaska, particularly among Alaska Native communities.
The Immaculate Conception Church in Bethel.
But the Jesuits leave a complicated legacy. Their methods of converting Native people to the religion, particularly in the first half of the 20th century, created generational traumas still felt to this day.
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Fr. Sean Carroll is the provincial of the Jesuits West Province, which oversees Alaska and nine other states.
Fr. Sean Carroll, provincial of the Jesuits West Province, speaks at an event recognizing nearly 140 years of Jesuit service in Alaska.
“Thank you for all that you have taught us about who Jesus is and how to love and serve Him wholeheartedly,” Carroll said. “I also thank you for your patience with us. For there have been times when we have sinned and when we have hurt you.”
Missionaries, including the Jesuits, forcefully converted and assimilated Alaska Native people into Western culture and religion. Students at Jesuit-run boarding schools were forced to abandon their Native languages and physically punished when caught speaking languages other than English. Native dancing and drumming were also banned.
The Jesuits West Province maintains a list of 150 Jesuits with credible claims of sexual abuse against minors or vulnerable adults. A quarter of the accused Jesuits served in Alaska at some point in time.
“I ask for your forgiveness for all that we have done that was not rooted in Christ and love for Him, and for when we did not value your culture nor recognize the presence of God in you,” Carroll said.
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Carroll gave the order to withdraw from the state last spring. A big issue was the recruitment of Jesuits willing to travel and serve in remote villages. He told the congregation that the Jesuits’ work would continue, just without a permanent presence.
Fr. Rich Magner, one of the two remaining Jesuit priests in Alaska, attends a ceremony in Bethel.
Fr. Rich Magner is one of the two remaining Jesuit priests in Alaska. His last day serving Chevak, Hooper Bay, and Scammon Bay is June 30.
“We all always knew coming in, or should have known, that we’re not going to be here forever. It’s going to be mission accomplished at some point,” Magner said. “And then we hand it off to the diocese that we’ve helped create, and so that’s a good feeling.”
Magner’s next stop is a Clinical Pastoral Education residency in Tacoma, Washington.
The other remaining priest, Fr. Tom Provinsal, first came to Alaska in 1968 to teach. A fond memory, he said, was meeting Elders that practiced traditional subsistence lifestyles.
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“Some of the grandmothers, their fingers were just all bent with arthritis and stuff like that, you know, their whole lives they’ve been working out in the cold and the wet, doing food, sewing, all that kind of stuff,” Provinsal said. “I’d say I just feel very privileged to have come when I did come and to see that.”
Provinsal returned in 1975 as a priest and has served in the region ever since. After moving away, he plans to take a five month sabbatical. What happens next, he said, is in God’s hands.
Two lines formed in the aisle for communion at the end of the mass. After taking communion, Bethel’s Parish Administrator Susan Murphy gave a final thank you.
“It’s difficult to say goodbye to people who have been a part of our lives for so long,” Murphy said. “We know that you have done what was yours to do, and have taught us to do what is ours to do. We are grateful.”
Jesuit priests form a row along the altar of Bethel’s Immaculate Conception Church as members of the congregation lift their arms and pray.
Dominic Hunt, a Yup’ik deacon that flew in from Emmonak for the event, led the congregation through a final prayer.
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“Bless them with your wisdom, that they may be a word of hope, a world in need. We ask this through Christ, our Lord. Amen,” Hunt said.
About 70 people posed for a photo on the altar – priests, deacons, parishioners, Elders and children — many of them smiling, some standing quietly.
The photo doesn’t tell the whole story. But it’s a moment when gratitude, grief, and memory all shared the same room.
Bishop of the Diocese of Fairbanks, Steven Maekawa, stands in the middle of a crowd waiting to take a photo at Bethel’s Immaculate Conception Church.
JUNEAU, Alaska (KTUU) – The Supreme Court of Alaska will be taking up the case of the State of Alaska, Division of Elections v. Daniel J. Sullivan, Jr.
The oral arguments will be held Monday at 10 a.m. via Zoom, according to an order and opening notice.
The document also specifies that a decision is expected to be made before noon on Tuesday.
According to documents from the Division of Elections, the state must start printing ballots at noon on the same day.
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This comes after an Anchorage Superior Court Judge ordered Dan J. Sullivan on to the ballot Friday.
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