WV lawmakers put Medicaid expansion trigger bill on inactive calendar

The House of Delegates Rules committee moved the bill to the inactive calendar Monday because of strong assurances from the federal government that it will not change its share of the cost, said Deputy House Speaker Delegate Matthew Rohrbach, R-Cabell.

“That bill was, in effect, a message to Washington, and it got communicated back to me Saturday from someone dealing with the negotiations in Washington: they’ve heard us loud and clear. These changes to Medicaid don’t appear as though now they are going to occur,� he told reporters.

Medicaid is a joint health care program between the state and the federal government.

Under the Affordable Care Act, 41 states, including West Virginia, have expanded their Medicaid programs to cover families who make up to 138% of the federal poverty line. West Virginia expanded its program in 2014.

The federal government currently matches coverage of those in expanded Medicaid at a 90/10 match. As the federal government considers cuts to Medicaid, at least 12 states have enacted trigger laws like House Bill 3518 in case the federal government decides to lower the rate at which they fund the expansion portion of the program.

House Speaker Roger Hanshaw, R-Clay, said leaders are in communication almost daily with the state’s federal delegation.

“We got some very fairly encouraging news over the weekend that the most recent version of what the president and some of the leadership of the current Congress is pursuing doesn’t implicate that bill in the way that we were originally told that it would,� Hanshaw said. “So we didn’t feel a need to move forward at this time.�

Rohrbach said he feels confident that the federal government will not change the federal matching rate for the program.

“I was told Saturday by the congressional people that they have heard a firestorm over this from red states, blue states and purple states,� Rohrbach said. “We are all saying that the federal government made a deal. You’ve got to stay with it if we’re going to have to stay with it. That’s only fair, because the states just cannot absorb that kind of a new budget request.�

The bill originated in the House Finance Committee last week and was advanced to the floor, where it would have been on first reading Monday.

House Democrats have criticized saying that it would take health care from 160,000 West Virginians, including children, people with disabilities and the elderly.

“This is not what we were sent here to do, but unfortunately after 45 days of doing nothing, the Republicans have tipped their hand as to what their priority is, and that’s to take health care away from nearly 10% of our state,� Delegate John Williams, D-Monongalia County, said in a post on social media.

If the federal government dropped its Medicaid expansion match from 90% to 73%, the rate at which it funds the rest of the program, that would cost the state about $170 million in addition to the $100 million it already pays for Medicaid expansion, officials say. In West Virginia, 166,000 West Virginians are covered under Medicaid expansion.

Before the bill was pulled, health care advocates and Medicaid recipients gathered outside the House chambers Monday morning to urge lawmakers not to pass it.

South ÂÒÂ×ÄÚÉä resident Paula Lepp and her family would lose health care if Medicaid expansion were to be eliminated in the state. Lepp and her husband, a full-time storyteller, have qualified for Medicaid for a few years since the COVID-19 pandemic led to them losing nearly 80% of their income. Lepp was diagnosed with breast cancer last fall. She’s had several surgeries since then and is scheduled for another on April 18. Now, she worries she won’t have health insurance by then.

“I’m sitting here worried, stressed out about what that is going to look like for our family,� Lepp said. “What does that look like for my recovery, if we have to choose between finding the money for my surgery and finding the money to continue helping [my daughter] pay for college, or having her go into massive amounts of debt.

“What a horrible choice that we’re going to have to make,� she said.

Rich Sutphin, executive director of the West Virginia Rural Health Association, said that cutting Medicaid expansion would be devastating to the state’s rural hospitals, five of which are already at immediate risk of closure.

“A cut like this to our health care delivery system would be catastrophic for those five hospitals,� he said. “So we’re advocating for the House of Delegates to vote no on House Bill 3918.�

According to the West Virginia Center on Budget and Policy, Medicaid expansion contributes about a billion every year to the state’s health care economy.

“[Ending Medicaid expansion] would more than double the state’s uninsured rate, harm health, put hospitals at risk of closure, and likely result in a significant loss of health care jobs throughout the state,� the organization wrote in a post.

Dan Hager, executive director Ebenezer Medical Outreach, a free and charitable clinic in Huntington that provides care to people without health care and on Medicaid, also spoke against the bill.

“When we talk about how 166,000 of our friends and neighbors could lose their coverage, I know what that looks like,� Hager said. “That looks like someone you know, someone you go to church with, someone in your family, someone you work with, walking into the pharmacy to pick up their diabetes medicine, to pick up their blood pressure medicine, and finding out they can no longer afford it because they got disenrolled by their insurance coverage and they didn’t even realize. It means someone you know going to the infusion center to get their chemo delivered and be told that they’re not going to be able to get their treatment that day because they no longer have their Medicaid coverage.�