Health Insurance Story Archives - West Virginia Public Broadcasting

Senate Passes Resolution on Southern Border And Insurance Bill

The Senate passed 11 bills today and sent them to the House of Delegates for consideration. The Senate also advanced more than 20 other bills, seven of which are House bills. There was also emotional debate around a resolution.

Senate Resolution 42

Senate resolutions are a form of legislation on things like rules for the legislature, or to express sentiments. They can be a symbolic way of issuing support, which was the case for today’s Senate resolution.

Senate Resolution 42 supports Texas Governor Greg Abbott in using every tool and strategy, including razor wire fences, to secure the southern border.

The resolution also calls out President Joe Biden and chides him for a so-called refusal to secure the border.

Sen. Mike Stuart, R-Kanawha, is the lead sponsor of the resolution. He said he visited the border and saw the challenges the state of Texas is facing.

“As best we can tell, I’d say as best we can tell because we don’t know the numbers,” Stuart said. “At least eight million illegals have crossed across that border, who’s coming across that border.”

Stuart said that terrorists, human traffickers, child predators, and violent criminals are crossing the border everyday.

“We also know there are a lot of really good people coming across that border, looking for a better life. Texas governor Abbott is trying to provide some defense of that border, not only on behalf of Texas, but on behalf of all states, including West Virginia,” Stuart said.

Sen. Mike Caputo, D-Marion, was the only no vote on the resolution.

“That was a wonderful campaign speech,” Caputo said. “That’s what I think this resolution is all about. I want to begin by saying I certainly support a secure border.”

Stuart is running for Attorney General in the upcoming election. Caputo expressed concern for some of the measures supported in the resolution.

“We’re going to support utilizing every tool, including razor wire fences for innocent children that are being brought here by others?” Caputo said. “We’re going to support using razor wire fences. Have we lost our minds? Have we lost our minds? There’s no one of us in this chamber that doesn’t care about children. Razor wire fences!? It’s insane! I might be the only no vote up there. And I’m not ashamed of that. I’m not one bit ashamed of that. Because I’ll feel good about my vote. And I’ll feel good about my career here. I don’t feel good about the direction we’re going as president.”

Caputo is not running for re-election.

Senate Bill 375

A notable bill today was Senate Bill 375. The bill affects non insurance health plans known as Health Care Sharing Ministries (HCSM).

In HCSMs, members pay into a pool of money that is available upon approval if one of the members needs medical care. Members typically submit the bill for their health care to the organization, and if approved the care is paid for.

Organizations like this were prevalent among Amish and Mennonite communities for decades but have recently risen to mainstream popularity following the passage of the Affordable Care Act. Members of these organizations are exempt from the tax penalty originally required in the law.

They are not for profit organizations and are exempt from the regulations and oversight that insurance companies adhere to. That has raised concerns about consumer protection and solvency of the organizations.

Senate Bill 375 confirms the state insurance commissioner’s practice of not participating in the regulation of these programs.

The bill also requires the HCSMs to prepare an annual audit and to provide a written disclaimer notifying members, and potential members, that HCSMs are not an insurance policy and coverage of medical bills are totally voluntary and that members are ultimately personally responsible for the payment of their own medical bills.

Some public colleges and universities have a requirement that students have health care insurance. This bill states that HCSMs also would satisfy this requirement.

Michael Oliverio, R-Monongalia, said this bill will help students whose parents are uninsured.

“With the absence of this legislation, if those students’ parents are participating in a Health Share ministry program,” Oliverio said. “That will not count as insurance, as judged by the higher education institutions and in turn, those students or their parents would have to pay thousands of additional dollars during their college years to meet the health insurance requirement.”

Caputo was the only no vote on the bill as well. He said these programs are not cost effective.

“I’ve done some research on it, Caputo said. “I found that a lot of procedures aren’t even covered. A lot of things have to come out of pocket and be reimbursed and some people may not have the money to pull it out of pocket.”

Free Guidance For West Virginia’s Uninsured On Jan. 9

Uninsured West Virginians can sign up for health insurance for free with trained counselors on January 9.

On Jan. 9, organizations from around West Virginia will work together to create the first Cover WV Day to offer the uninsured a free and guided path to health insurance coverage.

More than 20 organizations are joining in this effort to offer free assistance to those who need coverage. The WV Primary Care Association, the WV Navigator Program, the WV Office of the Insurance Commissioner, and many other non-profit organizations and community health centers have joined to offer more than 30 locations across the state for this one-day event.

Each location will offer walk-in hours where anyone can get questions answered or receive free help enrolling in health insurance.

All locations will be staffed by certified assisters such as Health Insurance Navigators or Certified Application Counselors who provide free help with Medicaid, Children’s Health Insurance Program (CHIP), and Health Insurance Marketplace enrollments.

The Open Enrollment period for the Marketplace ends on Jan. 16.

According to Jeremy Smith, the program director for WV Navigator, about 6 percent of West Virginians lack health insurance.

“We’re actually a little bit better than the national average as far as our uninsured rate is concerned, but we still have a ways to go,” Smith said. “I mean, we definitely know that there are over 100,000 people in West Virginia that don’t have health coverage and we think that the majority of them would probably qualify for either the West Virginia Medicaid program, the CHIP program for kids, or the plans on what’s called the Health Insurance Marketplace.

Organizers aim to educate West Virginians about the different options available to those needing health coverage.

“I do see that mindset from people that especially if they’ve lost Medicaid or if they’ve lost the job that provided insurance, they think they just have to go without until they find a new job that offers it, but with the marketplace, that’s not the case,” Smith said. “The Health Insurance Marketplace is designed for people that can’t get Medicaid, they can’t get Medicare, or they can’t get insurance through a job.”

West Virginia Medicaid and the Health Insurance Marketplace provide options for most people without coverage. According to Smith, four in five people who get a plan on the Marketplace can qualify for plans starting at under $10 per month this year.

“Even if they’ve checked in past years, and maybe they thought it was unaffordable, they should come back and definitely check again this year, because with all the updates the plans are affordable, all doctors are in-network, medicines are covered,” Smith said. “It’s just a really good option for people.”

For more information or a list of site locations, please visit www.wvnavigator.com or www.wvpca.org or visit the Facebook page.

Smith said anyone who cannot make it to any of the locations for the event can call 304-356-5834 with any questions.

Medicare Experts Encourage Members To Check Their Coverage

Experts advise Medicare members to review their coverage and watch out for scams during open enrollment season.

Medicare open enrollment began on Oct. 15 and ends on Dec. 7. Open enrollment is a window of time when people can review their Medicare plan options for the next calendar year, or sign up for coverage if they’d not signed up previously.

Rebecca Gouty is the West Virginia State Director of the State Health Insurance Assistance Program (SHIP) and the Senior Medicare Patrol (SMP).

“We at SHIP can help people locally in West Virginia understand the information if they don’t have access to a computer, or they don’t have access to the internet, we understand that there’s a lot of people that don’t have that,” Gouty said. “But then even if you do, you might be looking at information and you’re not understanding that. So you can definitely reach out to us. And we can help you walk through that process.”

There are some changes in Medicare coverage this year, due to the Inflation Reduction Act which lowered the amount the federal health insurance spends for prescription drugs and limits increases in prices.

“There’s changes to prescription costs, when somebody reaches the catastrophic coverage phase, their medicines will now be zero,” Gouty said. “And there’s also changes with the Extra Help Program, which is a social security based program that helps low-income individuals with their prescriptions. Everybody will qualify for what’s called full extra help on their prescription costs, which just means that their costs will be lower than the regular co pays. Whereas right now, there’s different levels of extra help.”

Gouty also warned Medicare recipients to watch out for scams during open enrollment season and to never give out their Medicare number to unsolicited callers.

“Just to remind everybody that Medicare will never call you so if you get a phone call and they say they’re with Medicare, no, they’re not and it’s okay to hang up the phone,” Gouty said. “Also Medicare does not send out new Medicare cards every year. So if you get a phone call from somebody who says, ‘Did you get your new 2024 Medicare card yet?’ Or, ‘Did you get a new Medicare card that’s plastic or gold?’ Those are all scams, do not give out your Medicare number to unsolicited callers.”

SHIP is a federally funded program through the Administration for Community Living, awarded to the Bureau of Senior Services to assist Medicare beneficiaries and their caregivers.

To learn more visit www.wvship.org or call 877-987-4463.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Charleston Area Medical Center and Marshall Health.

Health Insurance Options And Low Prison Incarceration On This West Virginia Morning

On this West Virginia Morning, West Virginia’s prison system has been in the news lately with deaths and staffing problems. A new report from the Prison Policy Initiative shows that the number of people incarcerated in the state is on the low end nationally. News Director Eric Douglas spoke with Wanda Bertram, the group’s communication strategist, about the report.

On this West Virginia Morning, West Virginia’s prison system has been in the news lately with deaths and staffing problems. A new report from the Prison Policy Initiative shows that the number of people incarcerated in the state is on the low end nationally. News Director Eric Douglas spoke with Wanda Bertram, the group’s communication strategist, about the report.

Also, in this show, since the end of the Public Health Emergency and the unrolling of Medicaid, health insurance workers are already seeing an uptick in inquiries. Emily Rice has more.

West Virginia Morning is a production of West Virginia Public Broadcasting which is solely responsible for its content.

Support for our news bureaus comes from Concord University and Shepherd University.

Caroline MacGregor is our assistant news director and produced this episode.

Listen to West Virginia Morning weekdays at 7:43 a.m. on WVPB Radio or subscribe to the podcast and never miss an episode. #WVMorning

Options In Health Insurance Marketplaces

Since the end of the Public Health Emergency and the unrolling of Medicaid, health insurance workers are already seeing an uptick in inquiries.

West Virginia Navigator provides free assistance to people in finding and selecting health care options through the Marketplace, Medicaid and CHIP.

The organization’s program director, Jeremy Smith, said the majority of the calls they receive are from people who have lost their Medicaid coverage.

“We’ve been pretty busy compared to this time last year,” Smith said. “We’ve even begun starting to come in on Saturdays so that we can help folks on weekends as well.”

Smith said most callers fall into three separate groups: those who could pick up insurance from their employer, those who qualify for Medicare and those who can purchase insurance on the healthcare.gov marketplace.

“We just kind of guide them through that whole process and talk to them about those three different options and then kind of zero in and help them figure it all out,” he said.

Smith said health insurance is complicated, confusing and full of acronyms, which is why people usually call West Virginia Navigator for assistance in acquiring health insurance.

“We spend a lot of time with each family to make sure that they understand exactly how an insurance plan works anytime they get it either through their employer or through the marketplace,” Smith said.

Smith said his biggest worry with pandemic-era benefits ending and many losing their health insurance is that people will choose to go without.

To learn more about West Virginia Navigator and how they can assist those who need health insurance, visit wvnavigator.com or call 304-356-5834.

PEIA Finance Board Decides On Straight Premium Increases

The Public Employees Insurance Agency (PEIA) finance board voted Thursday in favor of straight premium increases. The board’s decision follows four public hearings on changes to PEIA and comes after the idea of adopting two blended approaches was rejected.

The Public Employees Insurance Agency (PEIA) finance board voted Thursday in favor of straight premium increases.

The board’s decision follows four public hearings on changes to PEIA and comes after the idea of adopting two blended approaches was rejected.

Those plans would have resulted in lower premiums but higher deductibles, out-of-pocket and prescription costs.

Under the new plan, state employees and educators will see a nearly 24 percent increase in premiums, effective July 1. The change reflects a return to the 80/20 employer/employee premium split.

Employees insured by local government agencies that opt into PEIA can expect premium increases of 15.6 percent.

A monthly surcharge of between $140 and $150 will apply to spouses of active policyholders who opt into PEIA. The cost will vary based on the plan’s tier levels.

Also effective July 1, reimbursement to providers will increase to a minimum of 110 percent of Medicare’s reimbursement.

The changes to PEIA follow legislative efforts to rescue the insurance carrier from fiscal insolvency and more recently, the announcement by Wheeling Hospital that it would no longer accept the insurance carrier.

For more information on the new PEIA plan, visit peia.wv.gov.