West Virginians signing up for health plans in the new Health Insurance Marketplace will likely pay monthly premiums higher than national averages, according to data released Wednesday from the U.S. Department of Health and Human Services.
Officials blame the higher costs in part on the fact that only one company - Highmark Blue Cross Blue Shield of West Virginia - has opted to participate in the exchange, which is set to open enrollment Oct. 1.
The marketplaces were established under the Patient Protection and Affordable Care Act to help uninsured Americans purchase health care plans. Individuals and families with household incomes between 100 and 400 percent of the federal poverty level can also receive tax credits to offset the monthly premium cost.
Plans will be divided into four categories - bronze, silver, gold and platinum - with the bronze plan featuring lower premiums but a higher deductible, co-pays and other out-of-pocket expenses. Premiums will rise and expenses will fall as consumers choose which level of coverage they prefer.
On Wednesday, Department of Health and Human Services released a report detailing average premium prices consumers can expect in the exchange. The report said average prices were 16 percent lower than the Congressional Budget Office originally estimated.
The health department report analyzed average monthly premium rates for the 36 states where the federal government is either completely operating the exchange, or managing it in partnership with the state. It also summarized the average overall premiums for 47 states and the District of Columbia.
West Virginia has opted to partner with the federal government to manage its exchange. Beginning Oct. 1, consumers will be able to log on to www.healthcare.gov and compare and apply for one of 13 qualified health plans in the exchange.
The average monthly premium for the lowest-cost bronze plan will be $280 before any applicable tax credits, the report said. The lowest-cost silver plan will be $331.
The state rates are higher than the national average for each plan. According to the report, the national average for the lowest-cost bronze plan is $249, while the lowest-cost silver plan is $310.
Premium rates will still vary widely, depending on the number of people on the plan, their ages, whether they smoke and if they qualify for any tax credits.
A 27-year-old West Virginian looking for individual insurance could pay $185 a month for the lowest bronze plan, if they did not use tax credits. If that person made $25,000 a year, the plan price would fall $112 a month after tax credits.
Both rates are still higher than the average rates for the 36 states in which the federal government is helping to manage the marketplace. The lowest cost bronze plan averages $163 before tax credits, while the premium falls to $93 after factoring the credit for an individual making $25,000 a year.
Not every premium was higher than the average, however.
A West Virginia family of four with annual household income of $50,000 would pay a $282 premium for the second-lowest cost silver plan, according to the report. That is in line with the $282 average from the 36 other states.
The report said premiums tended to be lower in states where there was more competition and transparency in the exchange.
"In the 36 states included in this analysis, states with the lowest average premium tend to have a higher average number of issuers offering qualified health plans," the report said.