W.Va. uncertain on eve of health-care rollout
CHARLESTON, W.Va. -- One day before the Affordable Care Act goes into full effect and West Virginia opens its insurance marketplace, some West Virginians are excited, others ambivalent and some hate it, but most agree that they still don't know exactly what to expect.
West Virginia resident Corey Lake doesn't have health insurance now. Does he want to buy it on the Health Insurance Marketplace?
"That's a question that's kind of difficult to answer," he said. "Yes, but I want to buy health insurance that's a good value."
Lake, an employee for a software development firm, and his wife don't have insurance now, but their 8-year-old daughter does, .
Beginning in 2014, most people are required under the Affordable Care Act to have health insurance. Many will qualify for coverage under Medicaid, which will expand to allow people who make up to 138 percent of the federal poverty line, or $31,322 a year for a family of four.
Beginning Tuesday, people can purchase a plan on the Health Insurance Marketplace. Open enrollment for both the Marketplace and Medicaid lasts between Oct. 1 and March 31.
Lake says the health care reform law has overlooked people in his situation. He has a good job and makes an above average income for West Virginia, but his company doesn't offer health insurance.
Help with insurance costs, in the form of tax credits paid monthly, are available to those who earn up to 400 percent of the federal poverty line, or $78,120 for a family of three like the Lakes.
Still, the rate projections he's seen so far are high, he said.
Estimates released last week by the Department of Health and Human Services said that a family of four in West Virginia that makes $50,000 a year would pay $161 per month for the least expensive plan on the Marketplace, after tax credits are included.
"The government is asking a lot of trust for a pig in a poke," Lake said. "We've not seen what we are going to have to do yet, what we're going to have to buy into."
Exact rates on the Health Insurance Marketplace will be released Tuesday.
"I'll look [at the Marketplace]," Lake said. "I'm not going to shoot myself in the foot just out of spite... What it comes down to is if my employer doesn't offer health insurance, I'm probably not going to afford it. That's means I'll have to pay a fee."
Anthony Paranzino isn't shy about his opinion about Obamacare.
"I think it's a horrible bill," Paranzino, a longtime Charleston retailer and tailor, said, adding that the health care industry needed reform. "It's just terrible, but I think parts of it are good."
He and his wife, a state employee, and their children have insurance through the Public Employees Insurance Agency.
Paranzino, whose men's shop, Tony the Tailor, recently moved to a bigger location, said he needs to hire three more employees, but he hesitates to do so.
"I need to know what my costs are," Paranzino said. "Businesses don't spend any money unless they know, they've got to know what the number is. It's going to be interesting how this all plays out."
Coverage under the Markteplace will begin in January, but Paranzino, a longtime business owner in Charleston, said he's already seeing the effects of requirements to buy insurance. Last season prices increased on all the U.S.-made products he buys, he said.
"They're building in the cost of insurance into it," he said. "And we're looking at another cost increase for fall. Which means the consumer ultimately pays for it."
Paranzino would like to offer health insurance for employees as a benefit. As a small business, he won't be required to do so under healthcare reform, though.
His longtime health insurance agent has been helping him understand the new law and what it will mean. But there's still a lot of uncertainty, he said.
"Everybody I've talked to has said insurance rates are going up," he said.
He figures that many employers will shuffle their employees to the Health Insurance Marketplace instead of offering the coverage themselves.
"So I'm just trying to wait and see what happens with that," he said
He also wants to look at the Marketplace for an insurance plan for him and his family.
"I am going to look at the Marketplace and see, but I doubt they can beat PEIA," he said.
But while the Affordable Care Act means uncertainty and possibly higher costs for Paranzino, for others it may mean finally getting health care at an affordable price.
A pre-existing condition, diabetes, meant that Kathie Giltinan, of Charleston, has had to be in a high-risk health insurance pool through a state program, AccessWV. That meant good coverage but high deductibles, she said.
But "at least it's insurance," said Giltinan, a 61-year-old part-time instructor at Garnett career center.
Under the Affordable Care Act, though, health insurance companies are no longer allowed to disqualify people from coverage because of pre-existing conditions. AccessWV will discontinue because its members are eligible for coverage in the Health Insurance Marketplace.
"I welcome the health care reform," Giltinan said. "I think that although there may be problems to work out it's ultimately a good thing and a lot more people to have access to health care and access to preventative health care."
A lesson from her youth taught her early the importance of having health insurance. When she was in her 20s, she and her husband were on a tight budget that didn't include health coverage. When he got sick and had to be in the hospital, it was only charity care that kept them from having to pay exorbitant amounts for the health care, she said.
"It was a scary experience," Giltinan said. "I think when I was that young I didn't think anything was going happen to me. You're young, you're healthy, you're strong -- you just don't think that's going to be an issue." Reach Lori Kersey at firstname.lastname@example.org or 304-348-1240.