There were about 114,500 uninsured people in West Virginia as of 2019, representing 6.6% of the state’s population, according to data from the Kaiser Family Foundation (KFF). The nonprofit that tracks healthcare policy and data looked at those figures again in 2021 and found that of the people without health insurance in West Virginia, about 60,400 of them are marketplace eligible.
That means they could get a plan on the marketplace. These plans, like all major medical plans under the Affordable Care Act (ACA), cover pre-existing conditions along with a set of 10 essential health benefits. Among other things, the essential benefits include coverage for preventive care, mental health care and prescription drugs.
The ACA also created subsidies, aka premium tax credits, to help offset the cost of health insurance for people with low to moderate incomes. Anyone earning 100% to 400% of the federal poverty level qualifies for a tax credit. Most people qualify.
KFF estimates that of the people who are marketplace eligible but who don’t yet have health insurance in West Virginia, about 7% could get a bronze plan for free thanks to these tax credits.
The nonprofit also analyzed premium data for West Virginia in 2021 and found that average lowest cost plans by tier were as follows: $596 for bronze, $635 for silver and $825 for gold. Those are the average lowest cost for monthly premiums, but these averages don’t include subsidies that might further lower the cost.
Using our own marketplace, we found that a 40-year-old living in Harpers Ferry, WV, who earns $37,000 a year could find a bronze plan for $221.42 a month. That figure does include subsidies.
Where you live determines plan pricing and availability. There are at least two insurers offering marketing plans in West Virginia in 2021. These include Highmark and CareSource.
Sources
Kaiser Family Foundation, “Health Insurance Coverage of the Total Population”
Kaiser Family Foundation, “Marketplace Eligibility Among the Uninsured: Implications for a Broadened Enrollment Period and ACA Outreach” (January 27, 2021)
Kaiser Family Foundation, “Average Marketplace Premiums by Metal Tier, 2018-2021”
Kaiser Family Foundation, “Insurer Participation on the ACA Marketplaces, 2014-2021” (November 23, 2020)