The Open Enrollment for 2022 has ended. However, you can enroll in or change plans if you have certain life changes or qualify for Medicaid or CHIP. To determine if you qualify for a Special Enrollment Period (SEP), go to healthcare.gov or contact an agent or assister for help.
West Virginia has two companies offering health insurance through the Marketplace:
CareSource WV 1-855-202-0622
Highmark WV 1-855-329-1758
To determine if you can receive advanced premium tax credits (APTCs) and/or cost sharing reductions (CSR), consumer need to apply online through healthcare.gov. Below are lists of local trained Agents, Assisters and Navigators that can help you enroll and answer questions you may have. The following lists are by county:
You may also contact the West Virginia Insurance Commissioner's Consumer Services Division at:
2022 Legislative Update
February 28, 2022
Good News on Health Bills in WV Legislature
As we face down “cross-over” day in the state legislature, it feels like we are being hit with one bad bill after another. More about where some of those bad bills are landing later this week.
But there are two good bills moving forward:
HB 4252 – We are very close to victory!
We are optimistic (and you know how hard that is for us) that we will pass HB 4252 that lowers the private insurance copay cap on insulin to $35 a month and adds a copay cap of $100 on equipment, supplies, and devices. For continuous glucose monitors and insulin pumps, HB 4252 mandates that a person with private insurance will only pay $250 every two years for a new monitor/pump.
The prospects of passage of HB 4252 is very good but not a done deal. The Senate Health and Human Resources Committee must pass HB 4252 and send on to the full Senate for a vote. If we do pass this bill, our state law will do even more than the diabetes copay cap provisions that were part of the federal Build Back Better legislative package under debate in Congress.
Please Take Action and let all Senators know you support this bill!
HB 3001/S 688 – Positive Steps on the Medicaid Buy-In
HB 3001/S 688 will:
Remove a Significant Barrier to Work – the Medicaid Cliff
New Affordable Health Insurance Option Similar to Medicaid
Paid for with All Federal Dollars (using options/waivers that better use existing federal funds)
HB 3001/S 688 now has key republican sponsors in the House and Senate. We have received favorable feedback from the Health and Humans Resources Committees in both chambers. The DHHR has suggested some amendments are needed and we agree.
Help us keep up the drumbeat: Action Alert
Over the summer we hope to create a strong coalition specifically focused on building additional support for a Medicaid Buy-in. The voices of faith leaders and the small business community will be critical. Also critical will be collecting stories that illustrates the Medicaid cliff and the need for a Medicaid Buy-in.
February 9, 2022 – Fiscal Insanity – Once again the legislature is looking at slashing taxes for the very richest and putting programs that help struggling families at high risk
TAKE ACTION HERE
Here we go again. Our legislature is once again looking at slashing taxes for the rich while pushing aside the needs of West Virginians struggling to work and make ends meet. Make no mistake, HB 4007 will put Medicaid and health programs at great risk.
This week the House Finance Committee, chaired by Eric Householder (R-Berkeley), passed HB 4007 before most West Virginians even had a chance to read the bill. A full House vote could be as soon as Friday.
HB 4007 dramatically reduces revenue from the personal income tax 10 percent and cuts the state budget $265 million in the first year alone. That’s bad enough but this bill also creates a new permanent stealth “reform fund” that drains our critical state Rainy Day fund and restrains legislators’ future budget decisions. HB 4007 would force huge mandatory cuts to our budget and put at risk health programs and every service that state government provides – including education, road repairs, parks and recreation, police and fire department services, and more.
Any economist will tell you that cuts to the personal income tax disproportionately help the wealthy and do little to help struggling families. Eliminate the personal income tax and the richest 20 percent of West Virginians score an estimated 70 percent of the benefit. For those with income under $35,000/year, the cut is less than $39. Eliminate the personal income tax and the top one percent of the richest West Virginia households get a tax cut 44 times greater than a family in the middle 20 percent.
Supporters of HB 4007 say our state can afford this large tax cut for the rich because West Virginia has a large “budget surplus.” That is NOT true.
First, In West Virginia defining a budget surplus is a game of smoke-and-mirrors. It all depends on how the Governor defines the baseline (the funds government needs to keep existing programs running) and how future needs are projected. Our Governor says a program like Medicaid is “fully-funded” even though many critical jobs are vacant and remaining staff are overwhelmed.) And our Governor’s budget is “flat” – no increases to cover inflation or any new costs.
Second, the current so-called budget surplus exists in great part because of a temporary flow of federal COVID relief dollars. If the HB 4007 tax cut is traced back to these federal funds, under federal statute and regulations our state must return relief funds.
Please tell your legislators to vote no on HB 4007. It is important that both Democrats and Republicans hear from you. Go to the Action Alert set up by our allies at West Virginia Center on Budget and Policy.
February 2, 2022 – Calls to the Senate to Support HB 4252 Needed
Just want to start this update by flagging for you our Take Action Alert on HB 4252.
Shout out to Brittany for putting this Alert together last week! Please take just a quick minute to send emails and call to show your support for helping West Virginians with Diabetes. This great bill has a very good chance of becoming law.
Opportunity to Express Support for Women’s Reproductive Rights
To counter HB 4004 (which bans abortion after 15 weeks with NO EXCEPTIONS – see January 14 below), Delegates Hansen and Walker (both Democrats from Monongalia County) introduced HB 4382 that protects women’s reproductive rights.
The bill would repeal restrictions and limitations placed on abortion care in the West Virginia statutory code that are not supported by science and medicine, for example the telehealth ban on medication abortions, restrictions on “dilation and evacuation” common method of abortion, and criminal penalties for abortion in our code. The introduction was covered by the Gazette-Mail.
Calls to your representatives in the state legislature in support of HB 4382 will demonstrate that you want our elected officials to stand up for women’s reproductive rights and oppose bills like HB 4004.
January 27, 2022 – A BIG WIN for West Virginians with Diabetes in the House
This bill has been sent to the Senate and referred to one committee, the Senate Health and Human Resources Committee. The referral to a single committee is a positive sign that this bill has support from the leadership in the legislature.
As highlighted last week, the bill creates a $35/month copay cap for insulin, a $100/month copay cap for supplies and equipment (for example needles and test strips), and a one-time $250 payment for an insulin pump that is available every 2 years.
Thank you to all who called your Delegates to urge them to vote for HB 4252. Now it is important to call your Delegate and thank them for voting to pass this critical bill. Thank you’s are very important!
January 20, 2022 – Retail Sales Tax Cut???
There will be a lot of buzz this session about a proposed retail sales tax cut (from the current 6% to 4.75%). Right now, it is not clear if this proposal will gain traction and start to move forward in the state legislature. Our colleagues at the West Virginia Center on Budget and Policy spoke out against the proposal in an interview with Metro News. Kelly Allen, Executive Director, warned that this tax cut without a permanent revenue replacement is fiscally irresponsible and could lead to cuts in health and human services programs in our state.
January 19, 2022 – TAKE ACTION TO CREATE A NEW MORE AFFORDABLE HEALTH INSURANCE OPTION!
HB 3001 creates a Medicaid Buy-in that allows West Virginians to pay a small sliding-scale premium to keep Medicaid or Medicaid-like coverage and not fall off the “Medicaid cliff” because their incomes slightly exceed Medicaid eligibility levels.
See this Gazette-Mail oped to read the story of how one Mom would be helped by a Medicaid Buy-in
The plan would cover a comprehensive set of benefits and have low deductibles and copays. The state already has the Medicaid Work Incentive (M-WIN) for people with disabilities.
Most, if not all, of the cost of this program would be paid for with federal dollars using federal options and waivers.
HB 3001, introduced by Delegate Evan Worrell, has bipartisan support.
HB 3001 is:
• Pro-Workforce Development - West Virginians can keep working or return to work without fear of losing affordable health insurance coverage
• Pro-small business – many small business owners can't afford to offer health insurance to workers
• Pro-Financial Independence - West Virginians can accept more hours or a promotion and not drop off the “Medicaid cliff”
• Pro-Family - West Virginians can marry without worrying about their new household income pushing them off the “Medicaid cliff”
HB 3001 needs to pass in the House Health and Human Resources Committee (then it goes to the Finance Committee).
• Delegate Matthew Rohrbach, Chair, House Health and Human Resources (304) 340-3221
• Delegate Dean Jeffries, Vice-Chair, House Health and Human Resources (304) 340-3149
Please click here to email or call and tell these key state legislative Committee Chairs that you support HB 3001.
It only takes a minute to let them know you are a West Virginian and why you want this bill to pass.
January 18, 2022 – Two Bills to Watch – Medicaid Buy-In and Lower Copays for People with Diabetes
Medicaid Buy-in program – HB 3100
Introduced by Delegate Evan Worrell R-Cabell 18) – referred to House Health & Human Resources then Finance Committee
Insulin copay cap $35 (now $100) and insulin supplies and equipment insurance copay cap $100 – HB 4252
Introduced by Delegate Rohrbach R-Cabell 17) and referred to House Health & Human Resources
January 14, 2022 – Committee Passes 15-Week Abortion Pan with No Exceptions
TAKE ACTION TO SUPPORT REPRO RIGHTS!
We heard that the first two weeks of the state legislative session would focus on "social issues." For our state legislature, sadly that is code for attacking reproductive rights, LGBTQ rights, curtailing public health measures that help slow the spread of COVID, and restricting evidence-based substance use disorder treatment.
January 13,2022 - day two of the regular session, the WV House Health and Human Resources Committee passed HB 4004 to ban abortion after 15 weeks with NO EXCEPTIONS.
There will be a hearing on the House Floor on Monday at 3:00 pm (in-person only - no virtual link).
Please join West Virginians standing up for reproductive rights - Snow won't stop us!
If you can't make the hearing? This Planned Parenthood South Atlantic Action Page makes it easy to send a message to your legislator that you oppose bills to restrict reproductive rights. https://www.weareplannedparenthoodaction.org/a/stop-house-bill-4004
January 12, 2022 – Special Session Diverts COVID Emergency Funds to Incentives to Attract New Plant
The West Virginia state legislative season started with big bang this week with a special two-day session (the regular legislative session officially started on January 12th). The Gazette-Mail has a good report on the package of bills that passed. In a nutshell, the legislature used an expedited process to advance the Governor’s business. Six bills passed in two days that create financial incentives ($315 million) and large tax breaks (a minimum of $1 billion in tax exemptions) to lure a new Nucor steel recycling plant to be located in Mason County in the northern panhandle. According to media reports, the plant will hire 500 people and generate another 300 new jobs over ten years through the economic multiplier effect. Lawmakers estimated that the plant could bring in $480 million in tax revenue annually. However, the final decision for Nucor to locate its new facility in West Virginia has not been formally announced yet.
Very large tax breaks and financial incentives have become part of the norm for states to attract new businesses and industry to their states. The incentives and tax breaks are conditioned on the location of the plant in West Virginia and the generation of specified income and jobs.
WVAHC does not oppose economic development investments. However, we were concerned about how the financial incentives were paid for by the state legislature. $315 million was moved from the Department of Health and Human Resources (DHHR) and the Department of Homeland Security to the Department of Economic Development. The funds were then replaced with federal funds from the American Rescue Plan Act (ARPA - the law passed back in March 2021 to help states speed up the recovery from the economic and health effects of the COVID-19 pandemic). While this use of ARPA funds appears to be within the scope of the letter of the federal law, it is not clear it is the best use of these one-time emergency funds to help low-income families hit the hardest by the COVID-driven recession.
DHHR is already struggling to be adequately staffed, especially with the additional burdens created by the ongoing COVID pandemic. Last year the state’s fiscal year budget 2021-22 saw cuts across the board and many state agencies and offices were required to cut spending by 1.5%. While DHHR stated that all Medicaid and social services programs were fully funded, the final general revenue budget cut about $73 million from what the governor initially proposed in his zero-growth, flat state budget.
- WVAHC advocates for additional DHHR staff as well as extended hours for local DHHR offices. The 2022 Health Care for All Coalition 2022 legislative agenda (LINK) calls for desperately needed new state investments in many areas, including funding for:
- Public health by restoring lost funding to county health departments and prioritizing their budgets going forward, as well as increasing funding for community health initiatives and programs designed to prevent health issues associated with obesity (diabetes, heart disease, high blood pressure, and more).
- Mental health by re-establishing a system of home- and community-based care for vulnerable people with chronic mental illness with ongoing case management and support services.
- Mental health services for children in our schools and in other community settings by increasing funding for models that have been shown to effectively reach and help children develop.
- Substance Use Disorder (SUD) prevention, treatment, and recovery services for all West Virginians through expanded levels of funding and without arbitrary restrictions on programs supported by peer-reviewed expert research, including harm-reduction programs.
- Maternal and infant mortality by increasing funding for expanded home visiting programs, making doula care a covered Medicaid benefit, and providing expanded maternal access to mental health services.