WHEELING -- Health care advocates contend many West Virginians could face higher insurance premiums and reduced coverage unless Congress overrides President Donald Trump's latest executive orders.
Representatives of West Virginians for Affordable Health Care and WV NaviCare conducted a press conference Tuesday on the effects of new regulations and changes set forth by the Trump administration regarding enrollment in health insurance coverage through the Affordable Care Act's marketplace.
Kathleen Stoll, a representative of the West Virginians for Affordable Health Care organization, said several trade associations are opposed to Trump's executive orders, calling them "unworkable in any form." She said the associations believe Trump's orders would undermine protection for people with pre-existing conditions and lead to increased premiums and widespread removal of coverage.
Despite uncertainty, conference speakers encouraged West Virginians to study policy options and sign up for coverage during the open enrollment period. Open enrollment for health insurance plans on the ACA-mandated insurance marketplace begins Nov. 1 and ends Dec. 15. Speakers said the enrollment calendar has been shortened by 45 days from previous years, which could cause confusion both for potential enrollees and existing policyholders.
Stoll said, "I would want no one to be discouraged right now from talking to insurance navigators and exploring the marketplace. Everyone should look at the ACA marketplace. It is not dead. It is alive and well."
Stoll, who directs the West Virginians for Medicaid program, said 650,000 state residents receive assistance from Medicaid or the Children's Health Insurance Program, while 35,000 people buy insurance in the ACA marketplace. She said the vast majority of marketplace participants get tax credits or financial help with deductibles and co-pays.
"Medicaid is under threat, but the executive orders do not address Medicaid," she said. "The executive orders only affect the marketplace for private insurance or small business. There are other threats to Medicaid."
For instance, Stoll said leadership in Congress continues attempts to repeal the Affordable Care Act, "which would totally roll back expanded Medicaid." In West Virginia, 175,000 low-income workers benefit from expanded Medicaid, she added.
Stoll said Trump's first executive order allows insurers to offer skimpier, "bare-bones" plans and set higher rates for customers who are not healthy or who have pre-existing conditions. In the short-term, she said, people who have a premium tax credit are largely protected from immediate premium increases because the Affordable Care Act sets limits based on income.
"If you don't have a tax credit, you are immediately hurt by the impact of the executive orders," she said. "These new plans will leave out maternity coverage, mental health and prescriptions."
Stoll said Trump's second set of executive orders eliminated the cost-sharing reduction subsidies that reimburse insurance companies for providing coverage to lower-income families. Jeremy Smith, project director for WV NaviCare, said 85 percent of West Virginians qualify for the subsidies.
Stoll also thinks an administrative Affordable Care Act repeal could "hurt anyone who is older, has a pre-existing condition, has less than perfect health or anyone who wants to buy comprehensive coverage ... You will have no choice but to pay a higher premium for an insurance policy that won't provide the coverage you need."
Meanwhile, Smith said WV NaviCare is a free, nonprofit service to help anyone in West Virginia sign up for coverage through the marketplace, expanded Medicaid or CHIP.
Smith said people can sign up for marketplace plans online at healthcare.gov. However, he said the website is scheduled to be shut down for maintenance from midnight Saturday to noon Sunday every week in November.
Highmark Blue Cross-Blue Shield is offering marketplace plans in all 55 counties of West Virginia and CareSource is operating in 32 counties, he said.
Michele Selanik, a family nurse practitioner at FamilyCare Health Center in Charleston, urged the public "to try not to pay attention to all of the brouhaha coming out of Washington and not prevent them from signing up for health insurance."
Julie Schleier, a small business owner who has utilized ACA coverage since 2014, said, "I'm very, very thankful for the ACA. I don't know what I would have done without it. The ACA has just been wonderful for us."
Schleier, who broke her back in a fall and developed a rare auto-immune disease and severe osteoporosis, said, "Premiums do go up every year, but I don't have an option of going without health insurance. ... I read everything. I can have one plan and my husband can have a less expensive plan."
(Comins can be contacted at lcomins@theintelligencer.net)