One of the last undecided Democratic governors has opted to expand Medicaid.
West Virginia Gov. Earl Ray Tomblin announced his intention to urge funding of the expansion by the Democratic-led Legislature after considering it for nearly a year. The expansion to the full limit allowed by the Patient Protection and Affordable Care Act—all residents earning up to 138% of the federal poverty level—would add 91,500 enrollees to the 350,000 now in the program, according to state estimates.
“At the end of the day, we have weighed the options and believe expansion is best for West Virginia,” Tomblin said at a news conference.
The combination of the expansion and a coming health insurance exchange are expected to drop the number of uninsured state residents from 246,000 to 76,000 by 2017, a 69% decrease, according to state officials.
Although there was generally little doubt that the Democrat would pursue the expansion, his decision was delayed by a contractor's actuarial assessment, which was completed April 15. That report was delayed by slow responses by HHS and insurers in the state, according to state officials.
Tomblin cited the report's findings of relatively small costs to the state as primary reasons for backing the full Medicaid expansion, which will use managed care to control costs for all of the new enrollees. It will cost an estimated $375 million in state funds over 10 years, while the federal government would pay $5.2 billion over that time. The report identified over $50 million in annual savings the state could use to offset its share of the expected costs.
The governor and providers cited the need to financially support hospitals in the state, which face $155 billion in cuts to their federal support over 10 years to offset the law's costs.
“This expansion of Medicaid will replace a significant portion of those cuts and keep West Virginia hospitals financially healthy to serve our citizens,” said Thomas Jones, president and CEO of the largest system in the state, Fairmont-based West Virginia United Health System, at the news conference.
State officials said they will consider future changes to the Medicaid program, including the use of a so-called premium-support option in which federal Medicaid funds are used to help enrollees buy private insurance coverage in the coming insurance exchanges. That option is under consideration in several other Republican-leaning states and was pioneered by another Democratic governor, in Arkansas, but it drew derision from at least one West Virginia Democrat.
“Half of them ran away from it, and then all kinds of premium-support governors emerged, which of course has nothing to do with the real support encompassed in the Medicaid expansion,” Sen. Jay Rockefeller (D-W.Va.) said at the news conference.Follow Rich Daly on Twitter: @MHrdaly