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Open enrollment for Affordable Care Act Marketplace begins today


The Exponent Telegram

CLARKSBURG, W.Va.  — After a contentious year among politicians about the Affordable Care Act’s future, open enrollment for Marketplace health insurance plans begins Wednesday and ends Dec. 15 with increased premiums.

“It’s a very short period of time now,” said Doris Selko, deputy executive director for West Virginians for Affordable Healthcare.

A shorter time frame is one change to the Affordable Care Act, also known as “Obamacare.”

Premiums also have also changed, according to Richard Thony, a certified application counselor who works in three cities for the Monongahela Valley Association of Health Centers.

Highmark premiums have increased by 25 percent, and CareSource’s have increased by 19.6 percent.

Highmark and CareSource are the only two insurance companies offering plans on the Marketplace in West Virginia.

Premium increases were caused by insecurity and instability promoted by the continuing debate about the Affordable Care Act, said Kat Stoll, health policy analyst for West Virginians for Affordable Healthcare.

“To offset those increases, consumers will be getting more subsidies to bring the premium down,” Thony said.

People who qualify for subsidies may see a slight increase, but plans are available for as little as $75 with the subsidies, Thony said.

“If people do come and browse the Marketplace, they will see different plans, different options that they are providing that would fit their health needs,” he added.

About 85 percent of West Virginians who buy Marketplace insurance plans get premium assistance, Stoll said.

“And the way that help works is that under the Affordable Care Act, or ‘Obamacare,’ you don’t have to pay more than a set percentage of your income for health insurance,” Stoll said, adding that premium increases do not change the percentage a consumer has to pay. If household income increases or decreases, the percentage of the premium paid by the consumer would not change.

“The federal government has to spend more money,” she said.

Selko doesn’t see the premium increases as unreasonable, adding health care in general is expensive. But the increases are not out of range with typical increases, even prior to the Affordable Care Act, she added.

The only uncertainty is with cost-sharing reduction payments, Selko indicated.

A cost-sharing reduction payment is a discount that lowers the amount someone pays for deductibles, co-payments and co-insurance, according to These are considered extra savings, but only those enrolled in a plan in the silver category qualify for the savings.

“Particularly, the president’s recent executive orders have made it hard to predict what’s happening, so that increased the premiums because insurers were trying to cover themselves for the worst-case scenarios with some of these regulations,” Stoll said.

One of the president’s executive orders was a halt of reimbursements to insurance companies that are legally required to offer discounts on co-payments and deductibles to low-income consumers.

“There is a possibility they may try to renegotiate those rates. If not this year, then it’ll show up next year in the form of higher rate increases,” Selko said.

Thony said the worst thing someone could do is to not visit the website or allow him to help them navigate the process.

Prices and plans are available online at

In visiting the Marketplace and getting help to navigate the plans, some people may find they are eligible for Medicaid, which has minimal premiums, Stoll said.

“The Affordable Care Act is alive and well,” she added.

The Internal Revenue Service will be enforcing the penalty for not having insurance, Stoll said. The individual shared responsibility payment for not having insurance in 2016 is 2.5 percent of household income, according to

Thony will be available to help residents sign up for insurance or answer questions at these times: 9 a.m.-12:30 p.m. Thursdays, Clarksburg-Harrison Public Library in Clarksburg; 9 a.m.-12:30 p.m. Tuesdays, Monongahela Valley Association Health Center in Shinnston; and 9 a.m.-5 p.m. Mondays, Wednesdays and Fridays, Monongahela Valley Association Health Center in Fairmont.

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