By Louise Norris
January 19, 2014
Between expanded Medicaid and new enrollment in private plans through the exchange, West Virginia’s uninsured population has dropped from 13.5% of the overall population to 4.2% in mid-February, demonstrating the effectiveness of a coordinated and automated Medicaid expansion effort.
Enrollment in private plans in the WV exchange picked up significantly in January. By February 1, plan selections had been finalized for 7,962 people – a 63% increase just since the end of December. But out of all 51 exchanges, West Virginia had the lowest percentage of young people enrolling, with only 17% of the enrollees between 18 and 34. West Virginia also has the highest percentage (44%) of enrollees between the ages of 55 and 64, although this is down slightly from 45% a month earlier. It is too soon to predict how these numbers will impact the exchange going forward, and officials believe that the number of younger enrollees will increase in March. In addition, West Virginia’s population is aging faster than the national average, likely explaining why enrollment in the West Virginia exchange is skewing older than in other states.
West Virginia is expanding Medicaid, and is using auto-enrollment directly through the state’s Medicaid program, in addition to Medicaid enrollment through the exchange. The state has been working to contact residents who receive SNAP and WIC benefits, as well as households where some members were already receiving Medicaid benefits. By letting these individuals know about the expanded Medicaid program, the outreach program has been wildly successful. So far, 87,000 people have been enrolled in West Virginia’s expanded Medicaid program. The total eligible population was estimated at about 130,000, and the current numbers exceed actuaries’ projections for all of 2014 by about 25,000 – in short, West Virginia is a shining star when it comes to Medicaid expansion.
After first developing plans to operate a state-run health insurance exchange, West Virginia submitted a blueprint for a partnership exchange to the U.S. Department of Health and Human Services (HHS). The blueprint for the West Virginia Health Insurance Marketplace was approved in March 2013.
Gov. Earl Ray Tomblin’s administration cited cost, particularly the expense associated with information technology systems, as a key factor in deciding against a state-run exchange. Administration officials also said the partnership gives the state some control over the exchange.
Under the partnership, West Virginia is responsible for regulating the companies that sell health insurance policies on the exchange. Highmark Blue Cross Blue Shield is the only carrier offering coverage – a total of eleven different plans – in the West Virginia exchange. Carelink/Coventry Health had also been approved as a QHP, but pulled out in September 2013. The lowest cost bronze plan in the WV exchange costs an average of $280/month, higher than the national average of $249. After four months of open enrollment, 84% of enrollees in private plans in the West Virginia exchange had received premium subsidies – very close to the national average of 83%.
The state also oversees the In-Person Assister (IPA) program. Assisters will be under contract with the state and provide individuals impartial help with the enrollment process. In November, the state announced that it would be hiring an additional 100 people to help residents enroll in the exchange and the state’s expanded Medicaid program.
The West Virginia Offices of the Insurance Commissioner (OIC) estimates that between 40,000 and 60,000 West Virginians will purchase insurance through the exchange. According to Kaiser’s State Health Facts, 14 percent of West Virginians — about 260,000 people — were uninsured in 2013. But by February 2014, that number had fallen to 4.2%.
West Virginia residents will enroll through the federally facilitated exchange; enrollment runs October 1, 2013 through March 31, 2014
State Exchange Profile: West Virginia
The Henry J. Kaiser Family Foundation overview of West Virginia’s progress toward creating a state health insurance exchange.
Let your West Virginia governor and legislators know how you feel about the state’s proposed health insurance exchange.West Virginia Governor Earl Ray Tomblin