By ERIN BECK
CHARLESTON, W.Va. — Friday is the final day for West Virginians to buy health insurance during open enrollment on the federal health insurance marketplace, found at Healthcare.gov.
Few West Virginians — about 10,000 — had selected plans, as of last week.
The health insurance marketplace is where to find plans that meet the standards of the Affordable Care Act, including the requirement to cover pre-existing conditions, offer “essential health benefits” and tax credits, and avoid a tax penalty for lack of insurance.
Open enrollment for plans that begin Jan. 1 ends Friday. People may sign up for marketplace plans later only due to certain life events, such as losing other coverage, getting married or having a baby.
As of Nov. 26, 2016, 7,876 people had signed up in West Virginia. Fewer people — 7,828 — had signed up by the week ending Nov. 25 of this year.
As of the week ending Dec. 3 last year, 10,860 had signed up in West Virginia. A total of 10,070 had signed up as of the week ending Dec. 2 this year.
About 34,000 West Virginians had signed up by the end of the enrollment period last year. About 10,000 were signed up through auto-enrollment, and about 10,000 signed up after Dec. 3 and before Jan. 31.
Jeremy Smith, outreach coordinator for First Choice Services, is concerned that people who could get better deals by comparing plans are planning to auto-enroll. First Choice runs a Navigator program, which helps people select insurance.
“The Affordable Care Act isn’t extremely popular,” he added. “If you call it the Affordable Care Act, versus Obamacare, it makes a huge difference in how willing someone is to sign up, as well.”
Last week, the U.S. Senate passed a tax bill that cuts the corporate tax rate from 35 percent to 20 percent and removes the individual mandate to purchase insurance. The House version of the bill does not remove the mandate, and the two bills still need to be reconciled before the legislation would go to President Donald Trump to be signed into law or vetoed.
Trump signed an executive order seeking to increase the use of plans that aren’t compliant with the ACA’s requirements. His administration also slashed the advertising budget for the Affordable Care Act by 90 percent and cut funding for Navigator programs that help people who are purchasing plans.
West Virginia’s Navigator program is one of only a few states that received full federal funding. Representatives of the two state Navigator groups said many people they have helped didn’t know the ACA is still law or whether they are still eligible for subsidies.
The Trump administration announced in October that it would not pay insurance companies cost-sharing reductions — financial assistance to insurance companies in exchange for selling cheaper “silver” insurance plans to people who make up to 250 percent of the poverty level. But about 85 percent of West Virginians are still eligible for subsidies based on income.
“Even the folks that are coming to us, they were under the impression President Trump did away with the mandate,” Smith said. “I just think there was a lot of confusion for folks. If they don’t know about programs like ours, they may not know where to turn to get that correct information.”
WV NaviCare typically serves older West Virginians who live in more rural areas, with limited computer skills. The program has been busy compared to last year. As of Monday, it had enrolled 450 people, according to Smith. During last year’s open enrollment — Nov. 1 through Jan. 31 — they served 374.
To reach First Choice, call 1-844-WV-CARES or 304-356-5834. Information also is available online, at wvnavicare.com. It can help by phone or in person.
“I think people that typically seek in-person help are continuing to enroll,” said Kelly Taylor Allen, lead marketplace navigator for the WV Healthy Start Navigator Project, at West Virginia University. “As an organization, our numbers are up.”
She said auto-renewal letters don’t have accurate subsidy information and urged people to seek correct information.
“For most people, nothing has changed,” she said. “For people who qualify for subsidies, they can still get coverage pretty affordably, in most cases, regardless of any noise or changes at the federal level.”
She can be reached at [email protected] or 304-598-5150.
Cabin Creek Health Systems also employs navigators. Craig Robinson, executive director, said prices, especially Highmark prices, are increasing. Insurance Commissioner Allen McVey approved 25.6 percent higher monthly premiums for Highmark, and 19 percent higher monthly premiums for CareSource, because of Trump’s decision to end cost-sharing reduction payments. Highmark and CareSource are the two companies that offer plans on the marketplace in West Virginia. Tax credits were expected to increase with the premium increases.
“Some people are just opting out,” Robinson said. “CareSource is a little less expensive, but they also have a much more limited network of providers, so it can be difficult to find specialists.”
A spokeswoman for CareSource, Francine Robinson, said the company had recently signed agreements with new provider groups.
CareSource expanded to 32 counties in 2017, and saw its enrollment increase to 5,100. Mike Ross, a manager, said the company expects enrollment to exceed that number this year. “The last week is always a blitz,” he said.
“Marketplace enrollment in West Virginia has seen a decline but not very significant.” he said. “Two primary reasons are the shortened open enrollment period and the uncertainty surrounding the ACA at the federal level.”
Most people are continuing to buy silver plans, which are moderately expensive and the best value, he said.
“The interesting thing about health care is health care seems to be just an unstable market,” he said. “What we will do is we will stay committed, in whatever the environment is, to provide quality affordable health care, especially to people who are vulnerable.”
Premiums vary by county, income, age and other factors. The Kaiser Family Foundation estimated premiums in each state for a 40-year-old single person and found that, in West Virginia, a 40-year-old making $20,000 would see a premium decrease in most counties for the lowest-cost bronze plan in 2018. For a silver plan, the same person would see increases for about half the counties, in the Northern Panhandle, North-Central West Virginia, much of Southern West Virginia and border counties with Ohio. It found decreases for the other half, along the Eastern side of the state and in the Eastern Panhandle.
Thomas Bias, director of the health research center at WVU’s School of Public Health and a health policy professor, noted that premium increases are a problem nationwide. He also noted that misinformation is circulating.
“I would be cautious about not enrolling because of the one bill going through the federal government,” he said, “because it may not get passed.”
He wondered if more people were on employer plans. “You’d really need Highmark for that,” he said. He also noted that some states do more to promote the marketplace than others.
Catherine McAlister, a spokeswoman for Highmark, said via email that she did not know Highmark’s current marketplace enrollment and to contact her after the Friday deadline. Calls and emails to the West Virginia Office of the Insurance Commissioner were not returned.
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