West Virginia Deductibles Skyrocket under the Senate Bill to “Repeal and Replace” the Affordable Care Act

Opponents of the Affordable Care Act (ACA) complain about high deductibles, but the Senate health care repeal bill would dramatically increase deductibles, rather than lower them.

In West Virginia, 25,450 consumers in the state’s marketplace—more than three out of every four marketplace enrollees (77%)–would see their per person deductibles rise from an average of $1,770 to $6,000—a 239% increase. Very few people in the marketplace would be charged lower deductibles.¹

How the Senate health care repeal bill raises deductibles

• It cuts premium tax credits. Smaller credits would buy less generous plans that have higher deductibles. Average deductibles for insurance funded by these shrunken tax credits would rise from the current $3,600 to $6,000.²
• It completely eliminates the ACA’s payments that help low-wage, working families afford better coverage. The bill ends these payments—known as cost-sharing reductions (CSRs) —starting in 2020. Today, CSRs lower average deductibles from $3,600 to either $2,900, $800, or $300, depending on household income.

Deductibles are what people must pay for health care before their insurance kicks in. Raising them dramatically would impose financial burdens and make it harder for West Virginians to get the medical care they need. The Senate health care repeal bill takes West Virginia in exactly the wrong direction.

How the Senate health care repeal bill’s $6,000 per person deductible would affect West Virginians at different income levels

Out of more than 30,000 people (33,235) covered through West Virginia’s Marketplace:³

• 4,750 West Virginians now have average per person deductibles of $300. Their deductibles would rise by $5,700, a 1,900% increase.4 These are people with incomes between $18,865 and $20,505 for a single individual or between $38,571 and $41,925 for a family of four.5 For family coverage, deductibles are typically twice the per person amount.
• 9,983 West Virginians now have average per person deductibles of $800. Their deductibles would rise by $5,200, a 650% increase. These are people with incomes between $20,505 and $27,340 for a single individual or between $41,925 and $55,900 for a family of four.
• 4,217 West Virginians now have average per person deductibles of $2,900. Their deductibles would rise by $3,100, a 107% increase. These are people with incomes between $27,340 and $34,175 for a single individual or between $55,900 and $69,875 for a family of four.
• 6,500 West Virginians now have coverage with average per person deductibles of $3,600. Their deductibles would rise by $2,400, a 67% increase.6 These are people with incomes between $34,175 and $54,680 for a single individual or between $69,875 and $111,800 for a family of four.

The overall impact of the Senate’s health care repeal bill’s $6,000 deductibles on working West Virginians

Altogether, 25,450 West Virginians—most West Virginians on the marketplace—would be directly affected by the Senate health care repeal bill’s dramatic increase to deductibles for marketplace coverage. Their current average deductible is $1,770.⁷ The Senate health care repeal bill would raise that amount by more than $4,200—a 239% increase, on average.

If anything, this analysis understates the impact of the Senate bill, because it uses the $6,000 average deductible for 2017 bronze coverage to show what consumers would receive under the Senate legislation. In fact, the Senate health care repeal bill pegs premium tax credits to coverage less generous than any bronze plans sold in 2017. Based on the federal tool used to measure generosity of 2018 plans, deductibles for these plans are likely to be around $7,350.⁸

Consumers have other health care costs, in addition to deductibles. Marketplace consumers must pay premiums to enroll; and even after enrollees pay their premiums and deductibles, insurance companies typically charge copayments or other cost-sharing.⁹ The Senate health care repeal bill would add much higher deductibles to these already significant expenses of marketplace coverage.

For low-wage, working families and middle-income Americans, higher deductibles both increase financial burdens and raise barriers to getting needed medical care. Faced with higher deductibles, many people delay seeking health care until their medical problems worsen into emergencies. Others stop buying coverage, because it no longer seems worth the cost in premiums. Either way, consumers suffer.

The Senate health care repeal bill’s increase to deductibles is just one in a series of blows the legislation would strike against state residents.¹⁰ Put simply, the legislation would mean higher costs, lower-quality insurance, and less access to care for thousands of West Virginians who rely on marketplace coverage.

View full background and methodology for this analysis.