Medicaid Buy In, Other Health Legislation Advances During Saturday Session

Legislation focused on West Virginia health issues was a topic of debate and lawmaking during Saturday’s legislative session with many bills being passed through both chambers.

HB 3274 – Affordable Medicaid Buy-In Program Passed the House

Affordable Medicaid Buy-In Programs were a topic for debate in the House of Delegates.

House Bill 3274 would create the Affordable Medicaid Buy-in Program to help alleviate financial strain on recipients of Medicaid who start a job that disqualifies them from receiving their benefits.

Medicaid buy-in programs soften the “cliff effect” for recipients who lose their coverage when starting a new job that pays too much for Medicaid eligibility, until they can earn enough to afford other health insurance plans.

According to 2023 data from the U.S. Department of Health and Human Services, an individual would lose their Medicaid benefits in West Virginia when they earn more than $20,120 annually. The Affordable Medicaid Buy-in Program would allow that threshold to rise to 200 percent, or $29,160 annually.

Del. Evan Worrell, R-Cabell, explained the bill on the house floor.

“The idea behind this legislation is an attempt to mitigate the cliff effect for those individuals on Medicaid,” Worrell said. “The cliff effect occurs when wages from a new employment opportunity do not make up for a family’s loss of state benefits, putting the family in a worse financial situation.”

Del. Riley Keaton, R-Roane, asked Worrell questions and spoke in opposition to the bill on the House floor.

“So, we’re actually going to see is the public payer mix of patients grow pretty substantially for our health care providers,” Keaton said. “And then we’ll be faced with politically complicated decisions about how to make that program make sense.”

Jordan Maynor, R-Raleigh, spoke in support of the bill.

“I think my friend from the 15th (Keaton) brings up a great point. And it did get me thinking, but I think the intent of the bill is to move people off of Medicaid, keep a job, keep climbing that ladder of economic success, if they get off Medicaid completely eventually,” Maynor said. “And right now, it seems to be if we don’t do this, we’re incentivizing them to not keep their job, not take that pay raise and just be on Medicaid completely, which means no buy in from the patient.”

The bill passed the House with a vote of 73 yays, 19 nays and 8 absent, or not voting. The Senate will decide whether or not the bill makes it to the governor’s desk for his signature.

House Bill 2993 – Rural Emergency Hospital Legislation Passed Unanimously

House Bill 2993 would create a new hospital designation called “Rural Emergency Hospital.”

During discussion of the bill in the Senate Health and Human Resources Committee Feb. 21, it was stated that the new designation was intended to allow access to critical outpatient hospital services in communities that might not be able to support or sustain a traditional critical access hospital.

The bill passed the Senate unanimously on Feb. 25 and was sent to the House with a request to concur.

Senate Bill 613 – Certificate of Need was laid over

In recent years, “Certificate of Need” has been a topic of interest in the West Virginia legislature.

Since 1977, most West Virginia health care providers that want to open or expand facilities must obtain a Certificate of Need. The process is overseen by the state’s Health Care Authority. To acquire a Certificate of Need, facilities must prove that their community needs the proposed service.

The purpose is to regulate the healthcare market to discourage unnecessary duplication of services. However, some lawmakers and advocates have asserted in recent years that the process — which can cost providers tens of thousands of dollars — actually creates more barriers to care. They claim it protects existing providers from competition more than it protects patients.

Senate Bill 613 aims to amend state code relating to a certificate of need. Two sections relate to birthing centers which are healthcare facilities, staffed by nurse midwives, midwives and/or obstetricians, for mothers in labor, who may be assisted by doulas and coaches.

This discussion comes just weeks after the Senate passed House Bill 2789 removing the requirement that a birthing center obtain a certificate of need; and exempting birthing centers from obtaining a certificate of need, to the committee on Health and Human Resources on Feb. 8.

Senate Bill 613 would remove birthing centers from the list of reviewable services, providing that birthing centers are exempt from certificate of need review; and removing an exemption for hospital based birthing centers.Other code changes include, providing physician office practice meeting specified criteria may acquire and utilize one magnetic resonance imaging scanner and providing for data verification.

The bill was laid over on 3rd reading with the right to amend.

HB 3341 – Allowing for Cigar Bars 

House Bill 3341 would permit cigar bars and cigar lounges to operate in West Virginia resorts. It passed through the House of Delegates.

The bill was discussed in the House of Delegates with lawmakers arguing for personal freedoms, while others argued the bill would be a step in the wrong direction for tobacco cessation in West Virginia.

Del. Moore Capito, R-Kanawha, explained the bill on the House floor.

“The purpose of this bill is to permit cigar bars or cigar lounges, meaning an indoor area designated specifically for the smoking of tobacco products at a resort,” Capito said. “The bill defines what a resort is and puts forth a framework under which these lounges or bars are to operate.”

Some legislators argued that the definition of resort was not clear while others stood to share personal stories of tobacco use hurting them and their loved ones, arguing against exposing employees of resorts to secondhand smoke.

Del. Adam Burkhammer, R-Lewis, said he felt the bill would push West Virginia in the wrong direction.

“I believe that in recent years, we’ve even created a Tobacco Prevention Task Force. And now I’m not real quick on the budget, but I believe we give that about $3 million a year. I’m sure someone can probably correct me in that, but we’re moving in the wrong direction for things that we have said we did not want in public places anymore,” Burkhammer said. “And I will agree, and I support freedom, but I will tell you that you can take your freedom and smoke outside.”

After a half hour of debate on the House floor, House Bill 3341 passed to the Senate for their consideration with a vote of 57 yays, 33 nays and 10 absent, or not voting.