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Feds release cost estimates for health insurance exchange

CHARLESTON, W.Va. -- West Virginians will have fewer options for choosing health plans on the Health Insurance Marketplace than people in most other parts of the country, according to a report released Wednesday from the U.S. Department of Health and Human Services.

Uninsured West Virginians can choose from 12 different health insurance plans beginning Oct. 1, according to the report. On average, Americans will have 53 plans to choose from in the 36 states where the federal government will run or support the Health Insurance Marketplace.

Throughout the country, people will have as few as six and as many as 169 plans depending on the state to choose from in their marketplaces.

West Virginia's Health Insurance Marketplace has one company, Highmark Blue Cross Blue Shield of West Virginia. About 95 percent of Americans, however, will have a choice of two or more health insurance companies, according to the report.

The choices available to West Virginians on the marketplace closely mimic those available in the private market, said Perry Bryant, executive director of West Virginians for Affordable Health Care.

"It's a real reflection of what our limited choices are already," Bryant said. "I'm kind of disappointed we didn't attract more carriers."

He added that he is grateful that Highmark decided to join the marketplace.

People are not required to purchase their health insurance through the marketplace. But, with some exceptions, they must have health insurance coverage somehow, or face a tax penalty.

Plans in the Health Insurance Marketplace are divided into categories: platinum, gold, silver and bronze. Platinum plans have the highest premiums and lowest out-of-pocket costs. Bronze plans have the lowest premiums and the highest out-of-pocket costs.

Based on income levels, some residents will get tax credits for their insurance costs.

In West Virginia, before tax credits, a 27-year-old person would pay an estimated $185 a month for the lowest bronze plan, $218 a month for the lowest silver plan, $266 a month for the lowest gold plan, and $169 a month for the lowest catastrophic plan, according to the report.

The IRS will pay the tax credits in advance each month, so people will only pay the after-tax credit amounts each month, Bryant said.  

A 27-year-old making $25,000 a year would have paid $218 a month before tax credits but will pay $145 a month after tax credits for the second-lowest silver plan. The same person would pay $112 a month for the lowest bronze plans after tax credits, according to the report.

A family of four making $50,000 a year will pay $789 a month before tax credits and $282 a month after tax credits for the second-lowest silver plan. The same family will pay $161 a month for the lowest-bronze plan after tax credits, according to the report.

States with more competition in the marketplaces will have lower premiums, according to the report. Overall, premiums before tax credits are expected to be more than 16 percent lower than projected, according to the report.

Reach Lori Kersey at lori.kersey@wvgazette.com or 304-348-1240.


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