Children's Health Insurance Program Story Archives - West Virginia Public Broadcasting

State Health Officials Announce Completion Of Medicaid Unwinding

The West Virginia Department of Human Services Bureau for Medical Services released updated data following the completion of the state’s Medicaid unwinding period.

During the COVID-19 pandemic, Medicaid benefits were expanded and restrictions loosened to help immediate needs across the country.

Federal lawmakers reigned in this spending in December 2022 with the passage of the Consolidated Appropriations Act, returning eligibility to pre-pandemic levels.

“Completing the Medicaid unwinding process represents a significant milestone for West Virginia’s health care system,” said Cynthia Beane, West Virginia Department of Human Services (DoHS) Bureau for Medical Services Commissioner. “Throughout this period, the department has remained dedicated to ensuring that every West Virginian received the care they required, when they needed it most.”

The DoHS Bureau for Medical Services released updated data following the completion of the state’s Medicaid unwinding period, from April 2023 to March 2024.

During that time, the bureau conducted 520,729 Medicaid and Children’s Health Insurance Program (CHIP) renewals.

According to a press release, from April 2023 through the end of December 2023, 279,952 individuals were approved for ongoing coverage and 207,674 were not.

The 90-day follow-up on pending and incomplete renewals from January 2024 through March 2024 is not yet available.

The bureau said that of those not eligible for Medicaid or WVCHIP, 14,561 individuals have been transferred to the federal marketplace to be determined eligible for a health plan.

Medicaid enrollment at the beginning of the COVID-19 public health emergency was 504,760 in March 2020. Due to the continuous eligibility provision, Medicaid enrollment increased to 665,010 in March 2023. Medicaid enrollment as of April 1, 2024, was 516,500.

CHIP enrollment in June 2020 was 22,025; it went down to 18,138 in April 2023. WVCHIP enrollment, as of March 31, 2024, was 25,663 due to a net gain of 6,049 children to the WVCHIP program from the Medicaid program during the unwinding period.

Appalachia Health News is a project of West Virginia Public Broadcasting with support from Marshall Health.

Options In Health Insurance Marketplaces

Since the end of the Public Health Emergency and the unrolling of Medicaid, health insurance workers are already seeing an uptick in inquiries.

West Virginia Navigator provides free assistance to people in finding and selecting health care options through the Marketplace, Medicaid and CHIP.

The organization’s program director, Jeremy Smith, said the majority of the calls they receive are from people who have lost their Medicaid coverage.

“We’ve been pretty busy compared to this time last year,” Smith said. “We’ve even begun starting to come in on Saturdays so that we can help folks on weekends as well.”

Smith said most callers fall into three separate groups: those who could pick up insurance from their employer, those who qualify for Medicare and those who can purchase insurance on the healthcare.gov marketplace.

“We just kind of guide them through that whole process and talk to them about those three different options and then kind of zero in and help them figure it all out,” he said.

Smith said health insurance is complicated, confusing and full of acronyms, which is why people usually call West Virginia Navigator for assistance in acquiring health insurance.

“We spend a lot of time with each family to make sure that they understand exactly how an insurance plan works anytime they get it either through their employer or through the marketplace,” Smith said.

Smith said his biggest worry with pandemic-era benefits ending and many losing their health insurance is that people will choose to go without.

To learn more about West Virginia Navigator and how they can assist those who need health insurance, visit wvnavigator.com or call 304-356-5834.

Arriving At The New Normal

As the world steps into the actuality of the “new normal,” how do the end of these designations affect West Virginians?

The End Of The COVID-19 Public Health Emergency Brings Changes To Benefits

Thursday, May 11, the U.S. officially canceled the designation of COVID-19 as a public health emergency in the country.

Also this week, the World Health Organization (WHO) removed its designation for COVID-19 as a “global health emergency.”

For the first time in more than three years, the general public and health providers will live in a post-COVID-19 world, at least on paper.

As the world steps into the actuality of the “new normal,” how do the end of these designations affect West Virginians?

The Virus

While COVID-19 is no longer a health emergency, it is still an infectious illness that is a significant cause of acute illness and can cause long-term health complications all over the body known as long COVID. In special populations, COVID-19 is still life-threatening.

According to Clay Marsh, West Virginia’s COVID-19 czar, current research shows that staying current with recommended vaccination reduces the risk of long COVID, as does taking the oral anti-viral paxlovid or the drug metformin, if one tests positive for COVID-19.

“We have learned a lot about COVID-19, and to further ensure our health, we need to continue to practice what we learn,” Marsh said. “COVID-19 will remain an infectious disease that will cause illness, hospitalization and death, but by staying smart and following the guidance of our healthcare providers, we can keep each other safe and stop more preventive deaths from COVID-19.”

The Food and Drug Administration and the Centers for Disease Control (CDC) have recommended another booster for those over 65 years old and are four months or more from the last Omicron COVID-19 shot. Those who are immunocompromised will benefit from another shot as soon as two months after the last, according to the CDC.

The West Virginia Department of Health and Human Resources (DHHR) recommends West Virginians check the state’s vaccine calculator to see if they are due for a booster shot.

In West Virginia, 8,125 deaths have been attributed to COVID-19, as of May 10, 2023.

Pandemic-Era Healthcare Benefits

During the Public Health Emergency, Medicaid and the Children’s Health Insurance Program (WVCHIP) suspended eligibility redetermination processes, allowing coverage to continue regardless of changes in circumstances.

However, Medicaid and WVCHIP continuous eligibility provision was separated from the Public Health declaration in December 2022. This signaled the beginning of the unrolling of beneficiaries from these programs.

“For the past three years, the Medicaid program has been growing,” said Rhonda Rogombe, health and safety net policy analyist for the West Virginia Center on Budget and Policy. “One because people were not losing coverage. And two, the pandemic triggered an economic downturn that like made a lot more people eligible for the program.”

When the upcoming unrolling of benefits was announced, advocates worried beneficiaries would lose their coverage because they may have moved over the pandemic.

“Most of the denials that we’re seeing on the national level, are for procedural reasons, which means that somebody didn’t determine their paperwork or fill it out correctly,” Rogombe said. “We don’t have specific state numbers yet. We still see them by the end of the month. But West Virginia follows natural trends when most people who are losing coverage are losing it because they didn’t complete and return that paperwork on time.”

Jaqueline Hale is the Virginia State Network Director at Unite Us. Unite Us West Virginia is a network of health and social service providers. The network is supported by an West Virginia-based Unite Us team focused on community engagement, network health and optimization and customer success. Hale also covers portions of southern West Virginia.

“The fact that people haven’t had to do this for three years, so one, that could be out of practice,” Hale said. “I know, I’m always struggling to find, you know, where’s the shot record? Where’s that last pay stub? Right? How do I download it from wherever if you even have that capacity to have access to an online payroll. So it’s just a heavy administrative burden and recognizing that a lot of our families, a lot of our individuals are dealing with multiple complex issues.”

Those who may have lost their benefits or health insurance coverage during the unrolling process can submit the required renewal forms for coverage redetermination through West Virginia People’s Access To Help (WVPATH).

For those who no longer qualify, West Virginia Navigator is a free, non-profit program that offers enrollment assistance for the Health Insurance Marketplace and is available to any West Virginia resident.

SNAP and Food Banks

According to advocates for food security, charitable programs are unable to support those facing hunger fully. A combination of charity and government assistance programs are necessary to help bridge the meal gap, especially in a post-COVID economy with record-breaking inflation rates.

Cyndi Kirkhart is the CEO of Facing Hunger Food Bank, based in Huntington. It is one of only two food banks in West Virginia. The other is Mountaineer Food Bank, based in Gassaway.

Food insecurity will only increase along with inflation costs. Kirkhart said she budgeted $2.5 million to purchase food for the Facing Hunger Food Bank in 2022. The bank actually expended $4 million to feed its community.

Along with other changes to beneficiary requirements, on July 1, the work requirements for the Supplemental Nutrition Assistance Program (SNAP) for “able bodied adults without dependents” resumes, statewide.

Since April 2020, the West Virginia Department of Health and Human Resources has issued SNAP emergency allotments, increasing each household’s monthly benefit.

Now, those monthly SNAP benefits have returned to the pre-COVID-19 Public Health Emergency level based on the household’s income, assets, household size, and other non-financial factors. About 170,000 households have been affected.

SNAP is a program of the U.S. Department of Agriculture administered by DHHR’s Bureau for Family Assistance.

The “able-bodied adults without dependents” work requirement reinstatement will impact SNAP recipients ages 18 to 49 without children or other qualifying dependents, and who lack an identified condition that would prevent them from participating in a qualifying work, volunteer, or education activity.

“The stigma associated with the word ‘able bodied’ insinuates that they are unable to ascertain work and that’s not entirely the case,” Devon Lopez, associate director of customer and community success at Unite Us West Virginia, said. “However, our platform really is designed to empower organizations to help connect individuals in need for services. And so really taking the stigma associated with what asking for help might look like for individuals in the community, and really empowering organizations to help be the advocate for them and connect them to those resources.”

According to the DHHR, all potentially affected individuals will receive a letter in mid-May with more information.

“We know that someone’s overall health is adversely affected by their ability to be able to access food and proper nutrition,” Lopez said. “So in the past three years, they’ve been able to access, you know, these benefits that have been providing them with food boxes and meals. However, as they no longer qualify on this public health emergency ends, and they’re, they’ll have to re enroll for these or just not qualify for them at all anymore, we’re going to see a severe increase in those with those food needs.”

Kirkhart said work requirements are more complicated for those living in rural areas.

“You know, obviously folks focus on some of the expectations that there’s work associated with getting benefits and those type of things,” Kirkhart said. “The narrative never changes about that, because we serve very rural and remote communities where there is no public transportation. There are few if any jobs are volunteer opportunities to complete hours.”

Kirkhart also said her food bank and its mobile units are already seeing an increase in need in the community from the beginning of this year’s unrolling of beneficiaries. She expects to see more families in need after their stores of food run out.

“We’re kind of seeing the increases that I kind of expected would occur,” Kirkhart said. “So right now we’re about 25 percent (of spent funding), over the previous like 23 percent. Our mobile pantries in this last month have really started to grow. So I expect statistically, after review of this month, we’ll probably see more than 35 percent because sometimes people had food resources, and you know, they had kind of stocked up in anticipation.”

Parents Urged To Check Insurance Status Ahead Of Likely Winter Illness Surge

As medical experts warn parents of a possible "tridemic" of RSV, flu and COVID-19, a pediatrician says it’s a good time to check your child’s health insurance in order to avoid medical debt.

As medical experts warn parents of a possible “tridemic” of RSV, flu and COVID-19, a pediatrician says it’s a good time to check your child’s health insurance in order to avoid medical debt.

Around 60 percent of kids are covered by Medicaid or the West Virginia Children’s Health Insurance Program, better known as CHIP.

Families using these programs for insurance coverage have been automatically re enrolled during the current COVID-19 federal public health emergency.

The public health emergency will remain in effect until mid-January, and the Department of Health and Human Services has promised to give 60 days’ notice ahead of letting the public health emergency expire.

But Dr. Jennifer Gerlach, vice president of the West Virginia chapter of the American Academy of Pediatrics, said now is the time to verify children’s insurance status ahead of any federal changes or costly medical bills.

“We don’t want it to be a situation where it’s harder for parents to seek health care for their children because of their health insurance status,” Gerlach said. “We want to make sure everyone is covered … so West Virginia children can get help when they need it.”

Health care accounts for one of the country’s leading sources of debt, and NPR reported more than 100 million Americans are saddled with medical debt.

Gerlach, who also serves as the state’s medical consultant for CHIP, said Medicaid and CHIP applications are down 30 percent.

Once the public health emergency is lifted, families will have to re enroll in Medicaid and CHIP.

“We want to make sure families are re enrolled so they don’t lose their coverage,” Gerlach said.

Contact the West Virginia Department of Health and Human Resources to check the status of Medicaid and CHIP coverage.

Bill Passes House to Fund CHIP

The U.S. House of Representatives passed legislation to extend the Children’s Health Insurance Program for five more years. All three of West Virginia’s representatives voted in favor of the bill.

Funding for the Children’s Health Insurance Program, more commonly known as CHIP, expired on September 30^th due to Congressional inaction. CHIP provides insurance to 9 million children, including more than 20,000 West Virginians.

A bill to fund the program has been languishing for several weeks in the Senate.

The House voted along party lines to extend CHIP funding through September of 2022. The bill also contains two years of funding for community health centers, whose funding similarly lapsed at the end of September.

However, the House version of the bill calls for extending funding to CHIP by charging higher Medicare premiums to seniors earning more than 500-thousand-dollars, and redirecting money from the Affordable Care Act’s prevention and public health fund to community health centers – a proposal that has been met with severe criticism from House Democrats.

The bill now goes to the Senate, but is not expected to pass as is.

Appalachia Health News is a project of West Virginia Public Broadcasting, with support from Marshall Health, Charleston Area Medical Center and WVU Medicine.

WVU Speakers, Panelists to Examine Child Health Care Policy

West Virginia University plans to host what it’s calling a summit meeting on health care policy for children on Thursday.

Scheduled speakers include former U. S. Sen. John D. Rockefeller IV and former U.S. Dept. of Health and Human Services Secretary and now American University President Sylvia Mathews Burwell.

Panelists will discuss challenges with children’s access to quality and affordable health care, including the 20-year-old Children’s Health Insurance Program, or CHIP, which provides low-cost health coverage to children in families that earn too much money to qualify for Medicaid.