The Dominion Post: Commission ‘happy’ insurance increases held to 18%

Monongalia County, West Virginia is a year into its ICHRA experiment, and the results make the case for the model. The County Commission approved roughly $7 million in employer contributions for 2027, up about $1 million, after switching last year from a traditional group plan to an ICHRA administered through Remodel Health. Under the arrangement, each employee gets an allowance based on age and family circumstances, then shops the market with an advisor. The commission refined its formula in year two, replacing assumptions like a spouse’s age with actual data. Costs still rise to 18%, but the county estimates it would face a 40% increase, to just over $9.3 million, had it stayed in the group plan. Of 265 employees, 96 will see no change in what they pay, 45 will save an average of $236.77 monthly, and 124 will pay more, though only 20 of those face increases above $100 a month. Commissioner Sean Sikora credits the decoupling from the county’s group claims history, the driver of its steep annual increases, and says employees can adjust coverage to their own needs. Even with transition bumps and early criticism, all three commissioners call the move the right one, a local-government proof point that ICHRA bends the cost curve rather than just shifting it.