Is Medicaid Expansion Contributing to WV Budget Crisis?

In 2013, Governor Tomblin chose to expand the state’s Medicaid program, providing healthcare coverage for 150,000 more West Virginians. Up until this point, Medicaid expansion has had no impact on the state’s budget.

That’s because from 2013-2016, the federal government paid for 100 percent of the additional people covered by Medicaid due to the expansion. For West Virginia, that federal funding totaled 700 million dollars.

But next year, the Medicaid expansion agreement between states and the federal government will begin to change.

“Starting in January of 2017, West Virginia will have to pay a 5 percent match for Medicaid Expansion. In the governor’s budget that’s 14 million extra dollars for next year,” said Renate Pore, director of health policy for West Virginians for Affordable Healthcare.

In 2018, the state will have to match 6 percent, then 7 the following year, until by 2020 the match will cap at 10 percent and approximately 50 million additional dollars out of the state budget to pay for Medicaid.

“Although over time the federal match goes down, if you really look at the implications on the health and wellbeing of the people in the state it’s actually a positive impact,” said Department of Health and Human Resources Secretary Karen Bowling.

Bowling said choosing to expand the state’s Medicaid program was hugely beneficial for both the people of West Virginia and the state’s hospitals. With more people covered by insurance, fewer were going to the emergency room and leaving hospitals on the hook for a bill they couldn’t pay, leading to lower overall healthcare costs in the state.

But advocates like Pore they are worried about how the state will continue funding Medicaid.

“We are concerned about where is the money going to come from for the state match…so yeah it puts a strain on the state budget and I guess you could say it is contributing to the deficit,” she said.

Pore said she thinks both the Medicaid program and the expansion are essential programs for West Virginia.

“But I’m not unrealistic. It is expensive for the state,” Pore said. “And even though we have a great federal match, it’s still a huge cost for West Virginia. The cost to West Virginia next year will be almost a billion – 1 billion – dollars and every year that goes up. So as an advocate my concern is to create some stable source of funding.”

Or Medicaid patients – expansion or not – may soon not have access to care.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from the Benedum Foundation.