CHARLESTON, W.Va. — West Virginia could see a total decline of as much as 30 percent in insurance enrollments on the exchange created in the Affordable Care Act by the time the numbers are finalized later this year, according to a state insurance official.
Near the close of 2017, the Centers for Medicare and Medicaid Services reported that 27,409 West Virginians had selected health plans on the Mountain State’s exchange via healthcare.gov for 2018 prior to a Dec. 15 deadline.
Ellen Potter, director of health policy for the West Virginia Offices of the Insurance Commissioner, said those numbers were down by about 6,600 people or 20 percent of the enrollment total for the previous year.
It’s one of the steepest declines in the U.S., but it’s not the final number.
“Even though they enrolled, not everyone always pays the premium, so we’ll get the true enrollment numbers then in March,” Potter said.
“I would say each year, after we’ve gotten our initial report, when we receive the report of ‘actual paid’ after that it’s usually at least a ten percent dropoff there.”
For that reason, a total decline in enrollments of 30 percent was not out of the question, Potter told MetroNews.
There are many potential reasons for that including an earlier deadline to enroll. “I do think there’s probably some people in that situation because they were used to it going to the end of January,” she said.
Other factors in the enrollment decline could include those aging into Medicare, moving into group health plans, leaving the state or losing income and qualifying for Medicaid coverage.
Others, Potter said, may have simply opted out completely for 2018.
“There are probably some others that, once they reviewed the prices in the plans, they may have made the decision just not to participate this year.”
While most West Virginians qualify for subsidies on the exchange to help with premium costs, about 14 percent of West Virginians who buy insurance via the marketplace get no help in the form of tax credits.
For 2018, Highmark Blue Cross Blue Shield raised rates by 28.6 percent and CareSource’s increase was 19 percent.
Highmark is statewide and CareSource offers plans in 32 counties. They are the only two companies with plans on the Mountain State’s exchange.
The new federal Tax Cuts and Jobs Act does lift the individual mandate — the requirement to have health insurance. However, that part of the tax overhaul law President Donald Trump signed in December does not take effect until next year.
“I’m sure there’s some people who didn’t purchase just because they don’t think they have to pay a penalty now,” Potter said.
Those people may be surprised at tax filing time long after the close of open enrollment. “Until 2019, there is a penalty in effect,” she said.
Penalties for not having health insurance are currently the larger amount of $695 per adult and $347.50 per child or 2.5 percent of annual household income above the federal filing threshold with potential adjustments for inflation.
Insurance plan enrollments and changes via healthcare.gov are only available now for certain life changes like loss of coverage, marriage, births, dependent additions or divorce.