Enrollment in the Affordable Care Act health insurance marketplaces fell in most states across the country in the past year, including West Virginia, while 15 states saw enrollment increases, according to a new Urban Institute report. But West Virginia and Louisiana had the MOST significant drops at almost 20 percent and 24 percent fewer enrollees, respectively.
The drop can likely be contributed to four things, said Urban Institute research associate Becky Peters: funding cuts to advertising about the ACA, the influx of short-term, limited care plans, a shortened enrollment period and higher premiums.
"The bottom line is that health insurance is expensive in West Virginia," she said. "And for people who are maybe deciding between whether to spend $500, $600 on a health insurance policy or meet their other basic needs, I think some folks were really in a tough position this year."
Additionally, marketing funding cuts contributed to widespread confusion about what exactly was going on with the ACA.
“Not just consumers, frankly policy makers were confused also," said Peters. "Folks were unsure if their plans were going to be available again this year, maybe they had heard that premiums were going up and they didn’t know how they were going to afford it. They didn’t know when to sign up and then a lot of people weren’t sure if they needed insurance at all. They’d heard the individual mandate had been repealed and they thought maybe they didn’t need to get insurance this year.”
Peters said it’s hard to quantify how much the confusion affected enrollment, but it certainly didn’t help.
Health policy analysts weren’t surprised by the drop in enrollment – the Trump Administration openly does not support the ACA – but the drop in enrollment in ACA plans will likely coincide with a rise in enrollment in short-terms plans that are cheaper but don’t offer nearly as comprehensive coverage.
“These are plans that – they might look like a regular health insurance plan, but they don’t have all of the benefits that an ACA compliant plan would," Peters said. "They’re really designed for people trying to fill short gaps in coverage so maybe between jobs or something.”
While these plans are a lot cheaper than ACA plans, she said, they don’t cover much and might exclude preexisting conditions.
Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Marshall Health, Charleston Area Medical Center and WVU Medicine.