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Study shows costs decrease under insurance marketplace

CHARLESTON, W.Va. -- Most people in West Virginia will pay less in health insurance premiums through the state's health insurance exchange than they would have in the regular insurance market before the federal Affordable Care Act was passed by Congress, according to a state-commissioned actuarial study.

The rates are dependent on getting younger, healthy people to sign up for insurance, officials added.

"There's very few that are going to fall into this demographic of paying more, and most are going to qualify for subsidies," Brandon Merritt, a health policy analyst with the West Virginia Center on Budget and Policy, said Thursday at a meeting of the Health Care Implementation Coalition. "That's going to actually be a good deal in the long term."

Couples who are 40 years old and make between $20,628 and $31,020 a year will have 82.3 percent lower premiums than they would have otherwise, according to the study.

A couple aged 60 making the same amount will save 90.4 percent on their insurance premiums.

Most women will pay less in insurance premiums in the health exchange than they would have in the regular insurance market, according to the study.

For instance, a 40-year-old woman who makes between $34,470 and $45,960 will see her premiums drop by 9.6 percent in 2016.

A 60-year-old woman making the same amount will see her premiums fall by 43 percent.

"For women, even at age 40, there's a decrease, particularly low income [women]," said Renate Pore of West Virginians for Affordable Health Care. "... Even the higher income ones will see a decrease, and that means they can actually get real coverage ... no gender ratings, no pre-existing conditions, no drop-you-when-you-get-sick.

"I mean, it's just tremendous," Pore said.

The reduced premiums are not universal. Twenty-year-old women who make between $34,470 and $45,960 will pay 44 percent more for their insurance premiums than they would have otherwise, provided they buy the insurance through the marketplace and not through their employer.

Young men with average to high incomes are one example of a demographic that may pay more for insurance if they go through the health insurance marketplace.

For instance, a 20-year-old man who makes between $34,470 and $45,960 will pay 92 percent more for insurance premium through the marketplace than what he would have paid otherwise, according to the study.

But those who are in that demographic may be few.

"I do think it's worth noting there's very few ... 20-year-olds making 400 percent of the federal poverty level," Merritt said. "That's $46,000. I would imagine that there are very few families [making] more than 400 percent of the federal poverty level that are shopping in the marketplace that don't have their insurance through an employer."

The state Insurance Commissioner's office commissioned the actuarial study.

Enrollment in the health insurance exchange begins Oct. 1. Coverage is set to start Jan. 1, 2014.

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


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