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.

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.

Health Legislation, Wills And Estate Planning On This West Virginia Morning

On this West Virginia Morning, the state recently received some bad health grades from the American Lung Association. Appalachia Health News Reporter Emily Rice sat down with Del. Matthew Rohrbach, R-Cabell, who is also a doctor, to get his thoughts on the state of health in West Virginia and what the legislature can do to help.

On this West Virginia Morning, the state recently received some bad health grades from the American Lung Association. Appalachia Health News Reporter Emily Rice sat down with Del. Matthew Rohrbach, R-Cabell, who is also a doctor, to get his thoughts on the state of health in West Virginia and what the legislature can do to help.

Also, in this show, in last week’s installment of the radio series “Getting Into Their Reality: Caring For Aging Parents,” News Director Eric Douglas spoke with a funeral director on planning ahead. This week, he speaks with Charleston Attorney Franki Parsons about wills and estate planning and the problems that arise if you don’t have them when you die.

West Virginia Morning is a production of West Virginia Public Broadcasting which is solely responsible for its content.

Support for our news bureaus comes from West Virginia University, Concord University, and Shepherd University.

Listen to West Virginia Morning weekdays at 7:43 a.m. on WVPB Radio or subscribe to the podcast and never miss an episode. #WVMorning

Physician And Lawmaker Talks State Health Issues

On this episode of The Legislature Today, West Virginia often gets poor grades for the health of its citizens. Recently, the American Lung Association rated the state as failing when it comes to several categories relating to smoking cessation. WVPB’s Appalachia Health News Reporter Emily Rice sat down with Del. Matthew Rohrbach, R-Cabell, who is a practicing physician.

On this episode of The Legislature Today, West Virginia often gets poor grades for the health of its citizens. Recently, the American Lung Association rated the state as failing when it comes to several categories relating to smoking cessation. WVPB’s Appalachia Health News Reporter Emily Rice sat down with Del. Matthew Rohrbach, R-Cabell, who is a practicing physician.

Also, after hearing stories in the House of Delegates about health care provider misconduct and foster families not receiving their proper funds, a proposal to split the state Department of Health and Human Resources into three cabinet positions was up for a final vote Tuesday. Randy Yohe has the story and outcome.

A bill allowing the Foster Care Ombudsman more authority to protect children in state care passed the Senate unanimously. As Emily Rice explains, the bill has been through many amendments before Tuesday’s vote.

Finally, the American Heart Association was in the rotunda this Valentine’s Day promoting heart health. Chris Schulz has the story.

Having trouble viewing the video below? Click here to watch it on YouTube.

The Legislature Today is West Virginia’s only television/radio simulcast devoted to covering the state’s 60-day regular legislative session.

Watch or listen to new episodes Monday through Friday at 6 p.m. on West Virginia Public Broadcasting.

Morrisey, Other State AGs Set To File Lawsuit Relating To Pistol Brace Regulation

Patrick Morrisey is one of more than 20 attorneys general set to file a lawsuit against the federal Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF). They look to overturn a January rule regulating stabilizing braces and similar accessories for pistols.

Patrick Morrisey is one of more than 20 attorneys general set to file a lawsuit against the federal Bureau of Alcohol, Tobacco, Firearms and Explosives (ATF). They look to overturn a January rule regulating stabilizing braces and similar accessories for pistols.

Stabilizing braces attach to ends of pistols, using velcro to attach around the forearm.

The ATF argues these accessories would effectively transform pistols into short-barreled rifles, which are regulated more strictly than handguns through extra taxation, registration and background checks. 

The agency said pistols modified with braces should be treated the same way, saying short-barreled rifles have the power of longer guns but are easier to conceal.

“This rule enhances public safety and prevents people from circumventing the laws Congress passed almost a century ago,” ATF Director Steven Dettelbach said in a Jan. 13 statement announcing the rule, called Factoring Criteria for Firearms with Attached Stabilizing Braces. “In the days of Al Capone, Congress said back then that short-barreled rifles and sawed-off shotguns should be subjected to greater legal requirements than most other guns.”

Morrisey decried the rule as federal overreach during a live streamed conference Thursday afternoon, calling it a “completely nonsensical regulation.” He also argued these braces are meant to increase accuracy and prevent recoil, touting those who would otherwise have more trouble carrying firearms as examples.

“We should not be making it harder for senior citizens and people with disabilities — and many disabled veterans — to defend themselves,” Morrisey said.

The rule went into effect Jan. 31 when it was published in the Federal Register. The lawsuit challenging it is set to be filed in U.S. District Court for the District of North Dakota Western Division.

W.Va. Scores Poorly Among National Tobacco Use Averages

The American Lung Association released its annual “State of Tobacco Control” report Wednesday, naming West Virginia among the worst-scoring states in the union.

The American Lung Association released its annual “State of Tobacco Control” report Wednesday, naming West Virginia among the worst-scoring states in the union.

The report evaluates state and federal policies on actions taken to eliminate tobacco use and recommends proven-effective tobacco control laws and policies to save lives.

According to the report, West Virginia lags behind when it comes to tobacco control policies and as a result, the state’s average smoking rates are 22 percent of adults and 40.6 percent of high school students.

“This gives us an important opportunity to improve the health of our state through proven policies, such as increasing funding for tobacco prevention and cessation programs aligned with the Centers for Disease Control and Prevention recommended level,” said Lance Boucher, division assistant vice president, Eastern, at the American Lung Association.

Tobacco use remains the leading cause of preventable death and disease in America and takes the lives of 4,280 West Virginia residents each year.

Jennifer Folkenroth, senior national director of the American Lung Association, said policy changes are the keys to reduce tobacco use and save lives.

“At this time, when really looking at West Virginia’s report card, the strength of the smoke free laws received a grade D. But of course, considering the loopholes that currently exist and continue to allow workers across West Virginia to be exposed to secondhand smoke,” Folkenroth said. “Unfortunately, West Virginia received a failing grade for all other areas of the report, including funding for state tobacco prevention programs, level of state tobacco taxes, coverage and access to services to quit tobacco, and, of course, ending the sale of all flavored tobacco products.”

It is estimated that 35 percent of cigarette smokers have a direct behavioral health disorder and account for 38 percent of all U.S. adult cigarette consumption. Despite the national cigarette smoking rate of 14 percent overall among adults, it is 23 percent for individuals with a behavioral health disorder.

“So between tobacco and mental health, it is so very important that we ensure that programs are integrated with behavioral health facilities to provide substance use disorder facilities with the tools to provide voluntary cessation programs to support these individuals in breaking free from nicotine addiction,” Folkenroth said.

To learn more about this year’s “State of Tobacco” report, visit lung.org/sotc.

Governor's Tobacco Task Force Requests $10 Million Less Than CDC Recommendation

Dr. Ayne Amjad, commissioner of the West Virginia Bureau for Public Health, and state health officer, recommends a $16.7 million budget for the governor's Tobacco Use Prevention and Cessation Task Force.

Dr. Ayne Amjad, commissioner of the West Virginia Bureau for Public Health, and state health officer, recommends a $16.7 million budget for the governor’s Tobacco Use Prevention and Cessation Task Force. That is $10 million less than the Centers for Disease Control and Prevention recommends.

The CDC ranked West Virginia 53rd in the country for smoking rates. According to the CDC, almost 24 percent of adults use tobacco in West Virginia, compared to the national average of 14 percent. According to the task force, West Virginia loses $1 billion annually in health care costs due to smoking, and a loss of $1.2 billion worth of production.

The task force was created through House Bill 4494 in 2020 with a budget just under $500,000. Its purpose was to collect data on tobacco use in West Virginia and develop advertising and programs to help with preventing tobacco use and assisting with cessation, or quitting, tobacco. These programs include the toll free Quitline, which received around 10,000 callers last year.

At the June legislative interim meeting of the Join Standing Committee on Health, Del. Barbara Evans Fleischauer, D-Monongalia, asked Amjad why the task force didn’t go with the CDC recommendation.

“To speak bluntly,” Amjad said. “We didn’t think proposing a $27 million budget would be looked as favorably upon as if we could cut it down to $16 million looking at the individual tasks.”

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