TL/DR –
Over 200,000 West Virginians get their health insurance through the Affordable Care Act (ACA), which President-elect Donald Trump tried to overturn during his first term. With a second Trump presidency looming, residents and healthcare advocates are concerned about potential changes to healthcare coverage and premiums. The potential repeal of the ACA and the expiration of tax credits under the American Rescue Plan and Inflation Reduction Act, which make ACA plans affordable in West Virginia, could leave many without access to coverage.
Concerns Over Health Insurance With Second Trump Presidency
Over 200,000 West Virginians rely on the Affordable Care Act (ACA) for health insurance. As President-elect Donald Trump prepares for his second term, fears are mounting about the future of health care coverage and premiums in West Virginia.
Among the insured, 51,000 West Virginians utilize the federal government’s health insurance marketplace, a provision of the ACA. Another 166,000 have Medicaid coverage due to ACA-led state program expansion. Uncertainty prevails about whether Trump and congressional leaders will attempt to repeal the ACA, with health policy analyst Louise Norris describing the situation as too soon to predict.
Despite the ACA being upheld by the Supreme Court in 2021, the messaging from Trump and Republican leaders remains unclear. During a debate with Vice President Kamala Harris, Trump hinted at a “concept of a plan” to replace the ACA, while House Speaker Mike Johnson promised “massive” health care changes if Trump was elected.
West Virginia has greatly benefited from the ACA, especially due to its income-based provisions designed to make health insurance affordable for lower-income households, which represent a significant portion of the state’s population. This has seen the state’s uninsured rate drop from 15% in 2013 to 5.9% last year.
The ACA also abolished lifetime limits on coverage, prohibited denial of coverage to children due to pre-existing conditions, and mandated coverage for adults with such conditions. It further enforced coverage for preventative health care without charging a deductible. Rhonda Rogombe, from the West Virginia Center on Budget and Policy, warns that ACA repeal could bring about a catastrophic situation in West Virginia and nationwide.
Apart from ACA repeal, changes to tax credits through the American Rescue Plan and Inflation Reduction Act could also disrupt health coverage for West Virginians. This state, which has the country’s highest premiums, relies on these credits, which are due to expire end of 2025, unless extended by Congress and Trump.
Local business owner, Venu Menon, and his family have been beneficiaries of the marketplace insurance. The Menons pay over $800 a month for “nominal coverage,” with the tax credits making it more affordable. Menon voices his concerns about the potential repeal of the healthcare law, fearing for those who would lose their coverage.
Ellen Allen, of West Virginians for Affordable Health Care, faces premiums of over $1,700 a month without the tax credits, which bring her total annual cost down from approximately $30,000 to $15,000. She urges Trump and Congress to uphold the tax credits and continue supporting the ACA.