CHIP 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.

Free Guidance For West Virginia’s Uninsured On Jan. 9

Uninsured West Virginians can sign up for health insurance for free with trained counselors on January 9.

On Jan. 9, organizations from around West Virginia will work together to create the first Cover WV Day to offer the uninsured a free and guided path to health insurance coverage.

More than 20 organizations are joining in this effort to offer free assistance to those who need coverage. The WV Primary Care Association, the WV Navigator Program, the WV Office of the Insurance Commissioner, and many other non-profit organizations and community health centers have joined to offer more than 30 locations across the state for this one-day event.

Each location will offer walk-in hours where anyone can get questions answered or receive free help enrolling in health insurance.

All locations will be staffed by certified assisters such as Health Insurance Navigators or Certified Application Counselors who provide free help with Medicaid, Children’s Health Insurance Program (CHIP), and Health Insurance Marketplace enrollments.

The Open Enrollment period for the Marketplace ends on Jan. 16.

According to Jeremy Smith, the program director for WV Navigator, about 6 percent of West Virginians lack health insurance.

“We’re actually a little bit better than the national average as far as our uninsured rate is concerned, but we still have a ways to go,” Smith said. “I mean, we definitely know that there are over 100,000 people in West Virginia that don’t have health coverage and we think that the majority of them would probably qualify for either the West Virginia Medicaid program, the CHIP program for kids, or the plans on what’s called the Health Insurance Marketplace.

Organizers aim to educate West Virginians about the different options available to those needing health coverage.

“I do see that mindset from people that especially if they’ve lost Medicaid or if they’ve lost the job that provided insurance, they think they just have to go without until they find a new job that offers it, but with the marketplace, that’s not the case,” Smith said. “The Health Insurance Marketplace is designed for people that can’t get Medicaid, they can’t get Medicare, or they can’t get insurance through a job.”

West Virginia Medicaid and the Health Insurance Marketplace provide options for most people without coverage. According to Smith, four in five people who get a plan on the Marketplace can qualify for plans starting at under $10 per month this year.

“Even if they’ve checked in past years, and maybe they thought it was unaffordable, they should come back and definitely check again this year, because with all the updates the plans are affordable, all doctors are in-network, medicines are covered,” Smith said. “It’s just a really good option for people.”

For more information or a list of site locations, please visit www.wvnavigator.com or www.wvpca.org or visit the Facebook page.

Smith said anyone who cannot make it to any of the locations for the event can call 304-356-5834 with any questions.

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.”

Unite Us W.Va. Provides Assistance During Rollback Of Pandemic Benefits

Now that the state public health emergency has ended, 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.

When the COVID-19 pandemic began, the federal government sought to help families through temporary emergency increases to benefit programs including Medicaid, Supplemental Nutrition Assistance Program (SNAP), and Children’s Health Insurance Program (CHIP).

Since April 2020, the West Virginia Department of Health and Human Resources (DHHR) has issued SNAP, CHIP, and Medicaid emergency allotments, increasing each household’s monthly benefits.

According to the U.S. Department of Agriculture (USDA), 37.3 percent of West Virginia households receiving SNAP benefits have children. About 170,000 households have been affected in the state.

Devon Lopez is the community engagement manager for Unite Us, West Virginia. She said these changes not only create a hunger cliff, but in rural communities, the rolling back of benefits could create food deserts. A food desert is an area that has limited access to affordable and nutritious food.

“So this kind of becomes a larger issue than an individual just not receiving enough, you know, benefits to receive food. This is being experienced across all social wellness, but obviously, SNAP is the latest to be hit with this,” Lopez said. “And so what we’re seeing in West Virginia, is that we know one in six West Virginians actually receive SNAP benefits. And beyond that, what we do know is that a lot of those folks who receive SNAP benefits are in our rural communities.”

Lopez said the rolling back of pandemic-era benefits often has negative effects on organizations that provide assistance, like food banks.

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.

“It is going to provide a lot of, you know, negative effects on the organizations or entities that may be providing those assistance over time and we’re gonna see those you know, pull back as well,” Lopez said.

Unite Us, West Virginia aims to mitigate the fallout from unrolling benefits by providing an electronic platform for people and organizations to find assistance.

“We enable cross-sector collaboration between community-based organizations, government entities, health systems, nonprofits, really bringing all of those folks together on one single platform or infrastructure electronically,” Lopez said. “I call it the three C’s. It allows these organizations to all collaborate, communicate and coordinate for an individual’s care together beyond their four walls.”

Lopez said Unite Us is able to bring everyone together at one single table to meet the individual in need, where they’re at, and provide care and assistance.

“We’re so community-driven, because there’s multiple of me across the country that live and work in the communities working to build trust,” Lopez said. “And we’re not just an entity that comes in and says we’re going to help you like a lot of times we see in West Virginia. I’m from here, I believe in this and I’m doing the work on the ground.”

Unite Us is a unique program, according to Lopez, because they provide a team that’s ready to support people and organizations every step of the way.

“And I think one of the most unique things about the work that we do is the fact that our platform is absolutely at no cost for our community-based organizations so they can leverage this technology, the platform for referrals for free at no cost,” Lopez said.

Officials Remind Recipients Of Public Assistance To Check Their Benefits Status

During a Justice administration briefing, Ret. Maj. Gen. Jim Hoyer, director of the Joint Interagency COVID-19 Task Force, reminded West Virginians who receive state assistance to check the status of their benefits in light of the ending of the National Public Health Emergency.

“This does not mean that COVID is over,” Hoyer said. “But what this does mean is a change in certain policies and funding in response to the pandemic that may have an impact on certain people in the state of West Virginia. Particularly those related to Medicaid, CHIP and SNAP.”

Since April 2020, the West Virginia Department of Health and Human Resources (DHHR) 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 will be affected.

With the emergency set to end on May 11th, those affected individuals can go to www.wvpath.org or call 1-800-642-8589 to check their benefit status.

“The joint interagency task force has been assigned to work with the governor’s deputy chief of staff, to work with the Department of Homeland Security and Emergency Management, FEMA, and the threat preparedness folks within the Department of Health and Human Resources and other agencies to make sure that close out is done correctly and in an expeditious manner,” Hoyer said. “So far facilities that have participated in these audits have received strong applause for their excellent record keeping and effective distribution of benefits. West Virginia is moving along just fine in those initial audits.”

Hoyer also noted the anniversary of the state’s vaccine calculator, noting that nearly one million calculations have been done using the online tool.

“It was the first of its kind in the nation and ours has become the national template,” Hoyer said. “And I believe we demonstrated that with this calculator, it is important that folks continue to pay attention and check the calculator.”

Hoyer also asked the public to keep up to date with their COVID-19 vaccinations, noting that 400 Americans still die each day due to COVID-19-related illness.

State Medicaid Fraud Office Expansion To Include CHIP Fraud Investigations

The Attorney General’s Medicaid Fraud Control Unit is expanding to include investigations of Children’s Health Insurance Program (CHIP) fraud across the state.

CHIP offers health insurance to children whose families earn too much money for Medicaid.

Attorney General Patrick Morrisey said this expansion puts West Virginia’s fraud unit more in line with the majority of states and that investigating claims of CHIP fraud will save taxpayers more money.

“I just view that if you have the ability to save an extra dollar more with really not much effort, why wouldn’t you do that for the taxpayers and for the beneficiaries of the program?” Morrisey said.

The expansion was announced during a Tuesday press conference scheduled by Morrisey, who touted the successes of the fraud control unit under his office over the past three years. During that time the unit was expanded from 12 individuals to 21 with the average amount of civil recoveries from fraud per year climbing 268 percent.

Investigations of Medicaid fraud were previously housed under the West Virginia Department of Health and Human Resources before being placed under the jurisdiction of the Attorney General’s office in 2019.