CHARLESTON, W.Va. — The thousands of West Virginians who buy their health insurance through the exchange created in the Affordable Care Act have less time this year to make decisions about 2018 coverage.
After months of debate on Capitol Hill about possible changes to ACA and unsuccessful attempts to implement those changes since the inauguration of President Donald Trump, the enrollment period on healthcare.gov opens — as scheduled — this Wednesday, Nov. 1.
This year, enrollment is available through Friday, Dec. 15.
“The open enrollment period is six weeks shorter,” said Jeremy Smith, outreach coordinator for First Choice Services and program coordinator for WV NaviCare.
In past years, exchange enrollment had continued into January.
First Choice Services is the operator for WV NaviCare, a federal grant-funded program providing free exchange help for West Virginians who may be enrolling for the first time, re-enrolling or switching health insurance plans during the open enrollment period.
“There are new plans and prices this year and it can be a little bit confusing sometimes,” said Smith. “Everybody’s situation is going to be a little bit different.”
Two companies offer different levels of health insurance plans at different costs on West Virginia’s exchange: Highmark West Virginia which is in all 55 counties and CareSource which is offered in 32 counties.
Last month, the West Virginia Offices of the Insurance Commissioner approved premium increases of 25.6 percent for Highmark and 19.6 percent for CareSource.
Days later, President Donald Trump announced the end of the cost-sharing reduction payments, or CSRs, paid to insurance companies to reduce health costs for low-income Americans.
Those payments are different than the subsidies to assist with premium costs that more than 80 percent of West Virginians have qualified for in past years and continue to qualify for, Smith said.
However, he noted, the only way to access those premium subsidies is by enrolling through healthcare.gov, the official ACA exchange site.
“The #1 problem we see is somebody doing a simple Google search about health insurance and they end up on the wrong website,” Smith explained. “Most of these other websites, you cannot get subsidies and what happens is you start getting calls from health insurance telemarketers.”
Those telemarketers are often pushing “limited benefit plans” which do not meet the minimum requirements for coverage as established in ACA, according to Smith. Because of that, people who purchase the plans have been penalized for lack of coverage.
In 2018, the tax penalty for not having health insurance is the larger amount of $695 or 2.5 percent of annual income.
Smith said WV NaviCare can help residents work through their options on the exchange which was designed for people who don’t have other health insurance options like Medicaid or an employer plan.
Certified health insurance navigators are available through the WV NaviCare helpline at 1-844-WV-CARES or 304-356-5834. The WV NaviCare website is wvnavicare.com. In some cases, in-person assistance can be scheduled.
There is no cost for the WV NaviCare advising services.
“We do this every single day, so we’re really experts in navigating the process,” Smith said. “We don’t work on commission. Our job is to make sure you get the best insurance at the lowest price possible.”
In Washington, President Donald Trump has continued his push for ACA repeal and replacement, though attempts at as much have hit multiple walls in the U.S. Senate creating uncertainty currently and beyond 2018.
Also uncertain is future grant funding for WV NaviCare which is in its final year.