CHARLESTON, W.Va. — Despite recent gains, over 28 million people still don’t have healthcare insurance coverage, but some nonprofits are coming together to help bring opportunities for enrollment to West Virginians within the Affordable Care Act insurance access arena.
WV ACA Navigator, a program offering enrollment assistance for the health insurance marketplace, as well as the nonprofit West Virginians for Affordable Health Care, met in Charleston Tuesday to kick off the open enrollment period for health insurance registration in the ACA Marketplace Plans, which begins Nov. 1 and lasts until Jan. 15. They also discussed the ways West Virginians can enroll, and the importance and need to have health insurance.
WVAHC Executive Director Ellen Allen said there are a lot of options for people to sort through when enrolling in the affordable care insurance.
“You can look at changing the coverage you have, securing the coverage you may not have, and because of some of the changes to the ACA, you may have an Employer-Based policy that maybe consumes 15% of your household income, that would make you eligible to look for a more affordable policy through the Marketplace,” Allen said.
WV Navigator Program Director Jeremy Smith said many will qualify for substantially lower costs this year if they get their plans through the Marketplace.
“We advise people to look at the new plans and prices released this year,” Smith said. “Getting help with enrollment or renewal is essential, as many people are overwhelmed by the options or may not realize how to shop for affordable health coverage. Unfortunately, there are a lot of plans online masquerading as legitimate Marketplace plans, so if you aren’t careful, you could end up spending too much for a plan that doesn’t cover much.”
According to WVAHC, having healthcare insurance– from medical, vision to dental— facilitates access to such care, is associated with lower death rates, and is overall linked to better health outcomes.
However, Allen said navigating the health care market can be very complex, and it’s important to get help from an expert, as the amount one pays for their insurance policy differs depending on a number of reasons.
“It’s something you can begin on your own but it’s really complicated, because your premiums may differ based on not only your household income but your zip code,” she said.
Of the 28 million across the nation still uninsured, WVAHC says the exact proportions vary from state to state– from a high of 17.7% in Texas to a low 2.8% in Massachusetts.
As West Virginia has the 34th highest share of people not insured in health care, Allen said this comes out to 6.8-percent, or roughly 107,000 residents. She said this is due to various factors.
“Some of that is because they don’t have Employer-Based, perhaps they make too much to be eligible for Medicaid and their past experiences they could not afford the premiums on the ACA,” Allen said.
However, Allen said as ACA, as well as policies such as the American Rescue Plan and the Inflation Reduction Act, have helped make health care premiums more affordable, West Virginians are all getting closer to being covered as a result. She said this is something which wasn’t the case 20 to 30 years ago in the state, when the number of the uninsured was at 20-percent.
Allen said WVAHC has also helped make health care more affordable over the years, as their mission is about bringing a consumer voice to public policy.
“We want to hear from consumers about the barriers they have felt to health care, and we want to work with lawmakers to improve policies that make health care more affordable and accessible to every West Virginian,” she said.
All Marketplace Plans cover:
.Ten essential health benefits, including prescription drugs, emergency services, and hospitalization
.Free preventative health services
.And, coverage for pre-existing conditions
Allen said if consumers want their coverage to begin Jan. 1 or to be ensured they have it for 2024, she advises people enroll by Dec. 15.
She suggests people start calling the navigator now to make it an easier process for them and to get on the right plan.
“You don’t want to pay for more coverage you need, but you also want to make sure you’re not vulnerable financially if something were to happen, so just being able to work through those can save you thousands of dollars a year, and it also makes sure you have the coverage you need,” Allen said.
Allen said open enrollment for Medicare for those 65 or older is also getting underway. She said navigators will be able to help people enroll for that, as well, and they can contact the State Health Insurance Assistance program at 1-877-987-4463.