Premiums will go up, on average, across the board—premiums go up every year. But a range of factors could drive higher-than-average increases in certain places. States that fell short of their overall enrollment goals, and where the people who did enroll are mostly older and sicker, are more at risk for large premium hikes. So are states that don’t have much competition among insurers.
“If you lose on all of those, then you’re really looking bad,” Pearson said.
And West Virginia lost on all three fronts this year. It only got about 60 percent of the way to its total enrollment target, Pearson said. And it has the worst mix of young adults in the country—just 19 percent of people who picked a plan through the state’s exchange were young adults, who are presumed to be healthier and thus help keep premiums in check.
Completing the trifecta, there’s only one insurance carrier—Blue Cross Blue Shield—in West Virginia’s exchange.
Hawaii is another consensus pick, and some experts say the state might never be able to support its Obamacare exchange.
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