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Highmark W.Va. reports surge in health plan enrollment

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According to Highmark West Virginia, 18,631 residents have enrolled in health insurance plans on the state’s Affordable Care Act exchange.

Health insurance enrollment numbers through the federal exchange surged to 18,631 between March 31 and the April 15 federal extension, Highmark West Virginia President Fred Earley said.

Highmark, the only insurer participating in West Virginia's Affordable Care Act insurance marketplace, also reported that 6,171 people have enrolled directly through Highmark since Oct. 1. 

The numbers released represent the highest jump in enrollment the company has seen since the ACA rollout; it reported in April that, as of March 31, 14,839 people had enrolled through the exchange and 5,292 purchased plans directly through Highmark. 

The company's exchange numbers are slightly lower than those released by the U.S. Department for Health and Human Services, which reported that 19,856 West Virginians had selected plans through the exchange between Oct. 1 and March 31. According to Earley, the discrepancy likely is because Highmark has eliminated from its final enrollment numbers people who did not pay their first month's premium or missed payments between Oct. 1 and March.

"Our numbers show who have enrolled with us as of today,” Earley said, “and we'll still be processing people who've signed up in April and May to reach a final number." 

The open enrollment period has now closed, and Earley said those who have missed the deadline will be subject to the tax penalties outlined by the law, with the exception of those who turn 26 between now and the next open enrollment period and those who do not earn enough to pay income taxes.

Earley said the uptick in enrollment puts Highmark's number "within striking range" of its original projection and accounts for more than 25 percent of the 99,000 West Virginians identified as eligible for plans under the ACA, which includes the previously uninsured. 

"The surge at the end [of enrollment] was very positive," he said. "We're pleased to see that, of all the sign-ups we've had, 64 percent were new members to Highmark West Virginia, so approximately two-thirds of those customers were not our customers previously." 

The DHHS also reported that 136,418 West Virginians enrolled in Medicaid and CHIP through the end of March. According to Jeremiah Samples, deputy secretary for the state’s Department of Health and Human Resources, West Virginia has enrolled 117,522 people in expanded Medicaid — more than twice the 63,000 that actuarial studies had predicted for the first year of enrollment.

In August, the DHHR combed through its database of those receiving Supplemental Nutrition Assistance Program benefits, Women, Infants and Children Benefits and those who already were enrolled in Medicaid and contacted them about their expanded Medicaid eligibility. According to Samples, the DHHR sent out two rounds of letters to those identified and encouraged them to auto-enroll in Medicaid, and the agency called each household to ask if residents had received their letter and wanted to enroll.

"When we engaged that auto-enrollment process to kick this off, we signed up 60,000 to 65,000, we really did increase those numbers significantly," he said. "I think we would have been above actuarial projections regardless of our auto-enrollment — there is a lot of interest in the program — but I don't think we would be at the current number without it."

There have been a few changes to the CHIP program, since the ACA took effect, that affect the level of modified adjusted gross income a parent can get for their children to qualify, Samples said, but the DHHR is not responsible for CHIP enrollment. He estimated that the DHHR has reached well above 75 percent of those eligible in the state. Studies projected that roughly 133,000 people were eligible for expanded Medicaid. 

"We're never going to reach 100 percent of the population," Samples said. "Just like when you look at literacy rates — you're never going to have 100 percent literacy, and you're never going to reach 100 percent of any population — but we think we've done as well as anyone could ever have expected." 

Perry Bryant, executive director of West Virginians for Affordable Health Care, said the state's decision to opt into Medicaid will be beneficial in the long run, as the federal government has agreed to fully fund the program for three years. According to Bryant, the low reimbursement rate offered by Medicaid will cause some primary care physicians to accept fewer Medicaid patients but the state is identifying ways to deal with that issue.

"They will need to develop a list of primary care doctors willing to accept new Medicaid patients; that would be extremely helpful," Bryant said. "One of the things you really want to do with these newly enrolled people is to have them establish a relationship with a primary care physician; anything they could do would be beneficial for them and the system as a whole."

Reach Lydia Nuzum at or 304-348-5189. 

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