West Virginia

West Virginia

West Virginia has by far the highest average unsubsidized premiums in the country (Wyoming and Alaska rank 2nd and 3rd). It also has the second smallest individual market in the U.S. (Alaska has the smallest), with just over 22,000 West Virginians enrolled in ACA policies statewide.

For 2023, they're looking at roughly a 5% rate hike for those who don't qualify for ACA subsidies. The good news is that, being West Virginia, the vast majority of those enrolled (95%) do qualify for financial help.

WV's ACA-compliant small group market is even smaller, just ~14,000 people; they're looking at roughly a 3.4% average rate hike next year.

CMS Logo

via the Centers for Medicare & Medicaid Services:

Today, the U.S. Department of Health and Human Services (HHS), through the Centers for Medicare & Medicaid Services (CMS), approved the extension of Medicaid and Children’s Health Insurance Program (CHIP) coverage for 12 months after pregnancy in Indiana and West Virginia. As a result, up to an additional 15,000 people annually – including 12,000 in Indiana and 3,000 in West Virginia – will now be eligible for Medicaid or CHIP for a full year after pregnancy. With today’s approval, in combination with previously approved state extensions, an estimated 333,000 Americans annually in 23 states and D.C. are eligible for 12 months of postpartum coverage. If all states adopted this option, as many as 720,000 people across the United States annually would be guaranteed Medicaid and CHIP coverage for 12 months after pregnancy.

West Virginia

Good grief.

West Virginia has the second-smallest ACA individual market enrollment total (Alaska has the smallest), while also being one of the only states left which has (until 2022) refused to use #SilverLoading in their premium pricing strategy to provide some relief to moderate-income indy market enrollees.

As a result of this and other factors, they now have the highest unsubsidized individual market policy premiums in the country (19% higher than the prior record-holder, Wyoming, which averaged $870/month in 2021), at $1,038/month per enrollee.

In 2022, this is gonna be even more jaw-dropping, as the approved rate increases for WV's carriers will average 12.8%, bringing the average premium up to a whopping $1,171/month per person.

The good news is that starting in 2022, as noted by Dave Anderson, it looks like West Virginia will finally join nearly every other state in Silver Loading as well, which will help a bit:

West Virginia

I've once again relaunched my project from last fall to track Medicaid enrollment (both standard and expansion alike) on a monthly basis for every state dating back to the ACA being signed into law.

For the various enrollment data, I'm using data from Medicaid.gov's Medicaid Enrollment Data Collected Through MBES reports. Unfortunately, they've only published enrollment data through December 2020. In most states I've been able to get more recent enrollment data from state websites and other sources.

For January 2021 and beyond, I'm using adjusted estimates based on raw data from the West Virginia Bureau for Medical Services.

West Virginia

 Now that I've developed a standardized format/layout & methodology for tracking both state- and county-level COVID vaccination levels by partisan lean (which can also be easily applied to other variables like education level, median income, population density, ethnicity, etc), I've started moving beyond my home state of Michigan.

Here's Oklahoma:

NOTE: The CDC lists ~279,000 West Virginia residents (a whopping 84.4% of the total fully vaccinated) whose county of residence is unknown, which would make the graphs below unusable. Fortunately, the COVID Act Now database appears to have acquired the actual county-level data directly from the West Virginia Health Dept, so I'm using their data instead for WV.

There are three insurance carriers offering ACA-compliant individual market plans in West Virginia: CareSource, Highmark BCBS and Optum, although Optum has barely any enrollees at all, and the other two combined only total around 21,000 people in the state. The preliminary 2021 rate filings for the WV individual marekt is around a 4.8% average increase.

I have no idea what the enrollment numbers are for WV's small group carriers, so I can't run a weighted average, but the unweighted average increase for 2021 comes in at around 3.8% across the five sm. group carriers:

There are three insurance carriers offering ACA-compliant individual market plans in West Virginia: CareSource, Highmark BCBS and Optum, although Optum has barely any enrollees at all, and the other two combined only total around 26,000 people in the state.

The final, approved average unsubsdized premiums for 2020 haven't changed from the requested rates--the weighted statewide average is a 6.7% increase.

Nothing terribly noteworthy about any of this, except that with that 6.7% increase, West Virginia has just taken the title for Most Expensive Obamacare Premiums in the Country, with average premiums averaging $990/month per enrollee, or nearly $12,000/year apiece.

This record was held by Wyoming last year (prior to that I believe Alaska had by far the highest rates in the country, until they instituted their ACA reinsurance waiver a few years back, which reduced full-price premiums by a good 25% or so).

MLR rebate payments for 2018 are being sent out to enrollees even as I type this. The data for 2018 MLR rebates won't be officially posted for another month or so, but I've managed to acquire it early, and after a lot of number-crunching the data, I've recompiled it into an easy-to-read format.

But that's not all! In addition to the actual 2018 MLR rebates, I've gone one step further and have taken an early crack at trying to figure out what 2019 MLR rebates might end up looking like next year (for the Individual Market only). In order to do this, I had to make several very large assumptions:

West Virginia has three carriers offering policies on the Individual Market: CareSource, Highmark and The Health Plan of WV (aka Optum). I was ble to find the hard enrollment number for CareSource, while both HighMark and Optum are redacted, so I based my enrollment estimates on 83% of last year's (WV's total ACA exchange enrollment dropped 17% this year). Even if that ratio is off, it won't make that much of a difference since the two are pretty close anyway (+5.9% and +6.5% respectively).

Statewide, unsubsidized West Virginians will be seeing roughly a 6.7% average increase...to a whopping $1,000/month on average, one of the highest rates in the country. Of course, WV is also one of the few states which, to my knowledge, is still refusing to Silver Load or Silver Switch their premium increases, which makes it even worse for the few unsubsidized enrollees they have.

Meanwhile, the unweighted average increase on the WV small group market is +11.2%.

Amidst all the depressing news about various GOP states moving backwards on healthcare policy by gunking up Medicaid programs to add draconian work requirements, lowering the eligibility thresholds, stripping benefits and so forth, there were two positive developments in deep red territory last week, both relating to Medicaid work requirements:

First, in West Virginia:

A bill that sought to place work or other requirements on Medicaid recipients in West Virginia has died in the House of Delegates.

A House committee put the bill on its inactive calendar Wednesday, Feb. 27, the final day that legislation could be passed in their chamber of origin. The full House earlier Wednesday debated the bill but stopped short of voting on it, and did not take up the bill during a late evening session before adjourning.

The bill would have required able-bodied adults to work, participate in workforce training or community service, or attend a drug treatment or recovery program for at least 20 hours per week.

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