CHARLESTON, W.Va. — Fewer West Virginians have health insurance through the Mountain State’s exchange for 2019.
In all, the Centers for Medicare and Medicaid Services reported 22,599 total enrollments, a number that’s down from the 27,000 West Virginians enrolled in exchange health insurance plans for 2018 which was also a reduced number from previous years.
Jeremy Smith, outreach coordinator for First Choice Services and project director for West Virginia Navigator, was not surprised.
“We saw the trend all through open enrollment that not quite as many people were coming to enroll this year, so I think it’s kind of what we feared,” Smith said.
Costs were a concern, said Smith, especially in terms of deductibles.
“A lot of people just thought that the deductibles were too high and then, where there is no penalty for not having health insurance this year, a lot of people decided to roll the dice and go without health insurance.”
The 6th enrollment period under the Affordable Care Act was the first since Congress removed the ACA’s tax penalties for not having being insured.
Smith, though, said those opting out likely do not make up the full enrollment decline amount.
With unemployment low, “There is a sizable chunk of people that’s been able to gain access to health insurance through an employer, so I think a lot of folks were able to transition off of the marketplace onto an employer plan,” Smith said.
“Then there’s also a constant shift between Medicaid and the marketplace, so it could just be right now that a lot of people are qualifying for Medicaid and then, in the middle of the year, their income may change and they may go back onto the marketplace.”
Nationwide, the CMS reported 8.4 million people selected or were automatically re-enrolled in plans through healthcare.gov during the 2019 open enrollment period which ended in December 15 compared with 8.7 million for 2018.
It was a shorter enrollment period with fewer available resources.
West Virginia’s one of 39 states using the healthcare.gov platform where subsidies were available to people who qualified.
For 2019, Highmark Blue Cross Blue Shield offered health insurance plans statewide while CareSource was in 35 western West Virginia counties.
The final enrollment numbers were released earlier this month.
Even though open enrollment has closed, Smith said some West Virginians could qualify for a special enrollment period under certain circumstances.
One of them is a loss of qualifying health coverage due to job changes or income adjustments affecting Medicare and Medicaid, individual or group health plan coverage that ends during the year and aging out of parental health coverage.
Other possible special enrollment period options include change in household size, change in primary place of living, change in eligibility for marketplace coverage and helping pay for coverage, enrollment or plan error and other situations.
Loss of coverage for not paying insurance premiums or revocation due to fraud or intentional misrepresentation do not count for eligibility for a special enrollment period.
Free assistance with enrollment is still available from West Virginia Navigator online at wvnavigator.com and by calling 844-WV-CARES.
Enrollments for Medicaid and the Children’s Health Insurance Program are not subject to an open enrollment period and, as such, are available all year.