West Virginians hope for health care deal as prices soar
By Stephen Baldwin, RealWV
Ena Basler, a resident of Forest Hill, is one of around 65,000 West Virginians who received health care from an Affordable Care Act (ACA) plan last year. As a full-time manager in the retail industry, she’s received her care that way for a decade now.
“This year it tripled in cost,” Basler said. “And I had to downgrade my plan, two or three tiers.”
Ena Basler, retail manager
Basler said her costs and coverage had stayed relatively flat over the last decade, but all that changed this year when the base coverage tripled in addition to higher costs with a lower-level plan. “I have a large deductible, and all my office visits are more, my prescriptions are more, so, overall, it’s a bigger chunk of change.”
The premium credits for ACA plans which made them more affordable for residents expired on January 1, after Congress failed to pass an extension. Basler hopes they will reverse course, saying, “They work for the people. They should try to at least fight for the people’s rights to have affordable healthcare. People are worried about how they can pay their bills if they get sick.”
The House of Representatives is set to vote on an extension of ACA premium credits soon, perhaps as early as today, following a successful discharge petition supported by all elected Democrats and a handful of Republicans. If it passes, it will likely face changes or rejection in the Senate.
Burgess Everett of Semafor reported on Wednesday that a bipartisan coalition of senators are working on a compromise proposal that would extend the credits two years, institute income caps, eliminate zero dollar plans, and extend open enrollment so people can still sign up for plans this year.
A request for comment to Senator Shelley Moore Capito was not immediately returned on Wednesday afternoon.
Robert Bittinger, self-employed realtor
Some folks aren’t waiting for a solution from Congress. Robert and Sarah Bittinger of Crawley decided to find another option for their family. Last year, they paid under $300 per month for ACA coverage. This year, that cost soared over $3,200 per month.
“Thank goodness I have veteran status,” Robert says. “I’m going back to the VA (for health care).” His wife will still have to rely on a plan from the ACA marketplace which is more than double than they paid last year–even though it’s only for her.
Adding insult to injury, the Bittingers were charged via autopay this month for the new premium amount of more than $3,200 even though they discontinued coverage. “I told them I was not enrolling in their insurance, they gave me a confirmation number. All good, no! On December 30, they took out the money anyway!”
Victor Urecki, retired rabbi
Victor Urecki doesn’t have any other options. He is a retired rabbi living in Charleston. The health care premium for Rabbi Urecki and his wife, Marilyn, increased by $1,000 this year.
While he’s frustrated with the situation, he remains hopeful a solution can still be found. “I understand that the House is going to pass a 3-year extension. It looks like it’s dead on arrival in the Senate, but I’m wondering if the Senate would at least give it a one or two year extension. If we can’t cross the 60-vote threshold, we need both senators in West Virginia, because there’s a lot of people are going to be losing their healthcare right now.”
The Ureckis are in a unique position. Victor retired last year and is ineligible for Medicare for another eight months. He is also delaying taking Social Security as that would bump his income and health care costs even higher.
It’s a cost they have to bear, as they can’t go without insurance and aren’t quite at the age when they can receive Medicare.
“So we might be struggling the next year or so trying to figure out, you know, which money we can tap from our retirement to make sure we don’t reach the threshold of taxable income. But we have that ability,” Urecki says. “What does a family of four or five people with low income do? They need the health insurance. That’s who I worry about.”
The provisions of the ACA do allow for those who make 400% of the federal poverty level or lower to continue receiving premium credits in 2026 and beyond. But once a citizen hits that income threshold, there is a cliff on the other side where they see drastic price increases.
Lindsay Heywood, educator & fitness instructor
Lindsay Heywood, an education consultant and yoga instructor/studio manager reached that income threshold cliff this year.
”My premiums have increased this year by $360 as I have lost all access to subsidies,” she says. “My total health care premium cost now is equivalent to my monthly mortgage payment.”
Like Basler, she moved her coverage down to a lower tier to avoid even higher costs. This caused her deductible to triple and her co-pays to increase as well.
“I highly considered going without insurance for this year, as the increase puts such a strain on my finances,” Heywood explains. “However, I have some existing medical conditions that require more frequent care and preventative tests which would be too costly without insurance.”
So how’s she making it work? “I am selling some of my belongings for the cash. I am also working more hours and cutting my spending budget even further than I already had.”
Heywood hopes the situation causes voters to think twice in the next election.
“It feels like the idea of keeping Americans dumb and sick is the whole point. If we were well enough to pay attention to what is happening around us, not just stuck worrying about how to pay for subpar healthcare, perhaps our voting patterns would reflect it as well.”
