Health insurance subsidies on West Virginia’s exchange expand with start of April

CHARLESTON, W.Va. — Nearly 17,000 West Virginians currently without health insurance are now eligible for tax credits to help with premium costs under an expansion of the Affordable Care Act included in the American Rescue Plan, the latest pandemic relief package.

An estimated 3,900 of those uninsured people could qualify for fully-subsidized coverage, meaning no monthly premium costs for them, according to analysis from the Centers for Medicare and Medicaid Services.

The start of April brought the new pricing structure to the health insurance exchanges, also known as marketplaces, created in the ACA and open to people without employer-based health insurance options or other coverage like Medicaid or Medicare.

For people already enrolled in exchange plans, savings on premiums were possible.

“Everyone will qualify for increased subsidies that will help pay for their health insurance on healthcare.gov,” said Jeremy Smith, program director for WV Navigator, a non-profit organization providing free enrollment assistance.

WV Navigator was available by phone at 304-356-5834 and online at www.acanavigator.com.

“I’ve been a navigator since back in 2013 when the ACA rolled out in West Virginia and this is the most significant expansion that we’ve seen,” Smith said.

Under an order from President Joe Biden, a special health insurance enrollment period via healthcare.gov started for everyone on Feb 15, 2021 and will continue through August 15, 2021 for new enrollees and those already covered.

“What we’ve seen in the past is right around three in ten families in West Virginia didn’t qualify for any of the monthly subsidies that helps pay for their health insurance, but now almost everybody will qualify,” Smith said.

To see reduced premiums, he said people currently with plans through CareSource and Highmark Blue Cross Blue Shield would need to report a life change and update their information at healthcare.gov to access new premium prices.

The average premium reduction because of larger tax credits was estimated at $50 per person, per month and $85 per policy, per month.

In some cases, better plans would be available at lower costs.

“This is going to save people money. It’s going to be good,” Smith said.

“It really couldn’t come at a better time. We know that thousands of people across the state have lost their coverage over the past year due to the pandemic, so this is going to give all those people an opportunity to go ahead and get insurance for themselves and their family.”

For new rates to take effect in May, enrollment updates should be completed in April.

At of the start of 2021, 19,381 West Virginians had enrolled for health insurance via the exchange. The Mountain State is one of 36 states that utilizes the healthcare.gov platform to offer potentially-subsidized health insurance plans.

In the early years of ACA when there were penalties for not having coverage, that enrollment number was closer to 50,000.

“We know that there are probably a lot of people who have dropped out of the marketplace due to pricing or maybe they’ve been able to get a job that offers coverage, but I really anticipate a lot of people that could benefit from these new rates,” Smith said.

During the first two weeks of this year’s special enrollment period, 433 West Virginians became new enrollees.

Starting in July, additional health insurance savings will be possible for people who’ve received or been determined to be eligible for unemployment compensation during any week in 2021. Those could end up being fully-subsidized marketplace plans.

Smith also said people offered COBRA coverage should check with benefits administrators about the possibility of fully-subsidized COBRA plans for a period from this month through the end of September.





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