OPEN ENROLLMENT, HEALTH CARE & THE IMPACT of COVERAGE ACA Navigators, Health Care Advocates Address 2024 Marketplace Open Enrollment

(CHARLESTON, WV) – Nothing keeps West Virginians up at night like the cost of healthcare. And with the rising prices of food, rent, and childcare, too many families are left worrying about how to pay the bills and make ends meet. Meaningful health care coverage is critical to living a productive, secure, and healthy life.

“No one plans to get sick or hurt, but most people need medical care at some point,” said Ellen Allen, executive director of West Virginians for Affordable Health Care (WVAHC).”Health insurance covers these costs and offers many other important benefits.  It facilitates access to care and is associated with lower death rates, better health outcomes, and improved productivity.”

Despite recent gains, more than 25 million individuals still lack coverage, putting their physical, mental, and financial health at risk. However, the proportion of people without health insurance varies dramatically across states, from a high of 17.7% in Texas to a low of 2.8% in Massachusetts. Approximately 6% of West Virginians — roughly 100,000 residents — are  uninsured.

How do we fix this?

Enrollment in ACA Marketplace Plans for 2024 Begins on November 1, and runs through January 15. If you don’t have health insurance through a job, Medicare, Medicaid, the Children’s Health Insurance Program (CHIP), or another source that provides qualifying health coverage, you can find coverage through the Marketplace.

“Many people will qualify for substantially lower costs this year if they get their insurance on the Marketplace,” said Nicki Bailey, Assistant Program Director for WV Navigator. “We advise people to look at the new plans and prices. 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.”

In addition to making critical investments to fight the pandemic, the American Rescue Plan and the Inflation Reduction made health care premiums more affordable for millions of Americans who purchase insurance on their own.

In West Virginia alone, 21,000 enrolled in quality coverage and are receiving the advance premium tax credits, saving the average enrollee an estimated $700. For so many, this access to care means the peace of mind knowing that a medical emergency will not result in bankruptcy. 

Your savings depend on your expected household income for the year. You may qualify for a premium tax credit that lowers your monthly insurance bill, and for extra savings on out-of-pocket costs like deductibles and copayments.

By guaranteeing coverage that costs less than 8.5 percent of household income, the American Rescue Plan’s tax credits (passed in 2021) allowed millions of enrollees to find a quality plan for $10 or less per month and saved families an average of $2,400 a year on our insurance premiums.

“Enrollment in coverage supports the health and well-being of individuals and communities,” said Bailey. “Studies confirm that coverage improves access to care; supports positive health outcomes, including an individual’s sense of their own health and well-being; incentivizes appropriate use of health care resources; and reduces financial strain on individuals, families, and communities.”

All Marketplace plans cover:

• 10 essential health benefits, including prescription drugs, emergency services, hospitalization, laboratory services and mental health and substance use disorder services
• Free preventive health services at no cost to you when delivered by a doctor or provider in your plan’s network
• Coverage for pre-existing conditions

There are several ways to apply for and enroll in Marketplace health coverage:

• Call WV Navigator — A free non-profit program available to all in-state residents that provides free enrollment assistance — at 1-844-WV-CARES/1-844-982-2737 or visit ACANavigator.com
• Use HealthCare.gov to apply online

It is important to understand the changes in open enrollment as they are genuinely transforming access to coverage for millions, including tens of thousands of West Virginians.