The Times West Virginian

West Virginia

February 27, 2013

Groups says that expanded Medicaid will add W.Va. jobs

CHARLESTON — Expanding Medicaid will do more than provide coverage to 100,000 West Virginians, supporters of the federal health care overhaul argued Tuesday: It would also create 6,200 jobs while spreading $664 million through the state’s economy by 2016.

The advocacy group Families USA hired Regional Economic Model Inc. to develop the estimates, and presented the findings with West Virginians For Affordable Health Care at a state Capitol press conference. The jobs number reflects those directly employed by hospitals, doctors’ offices and other health care settings, but also assumes that the increased spending would spur jobs in the other sectors of the state’s economy.

“We have a once-in-a-lifetime opportunity to help our friends and neighbors get the health care they deserve while at the same time expanding jobs and economic activity,” said Perry Bryant, executive director of the state-based advocacy group.

Expansion supporters stress that the federal overhaul will fully cover the resulting costs from 2014 to 2016, and then gradually reduce its funding share to 90 percent in 2020. Gov. Earl Ray Tomblin is awaiting an accounting analysis before choosing whether to expand. He’s one of two Democratic governors who has yet to decide.

“There is no decision that Gov. Tomblin will make during his tenure as governor that will create more jobs or generate more economic activity than his decision to expand Medicaid,” Bryant said.

Medicaid is projected to consume $900 million in state spending during the budget year that begins July 1, up from $764 million two years ago, according to state officials. As the program relies more heavily on matching federal funds than state dollars, total spending during the coming budget year is expected to reach $3.1 billion.

The overhaul calls on states to expand Medicaid starting in 2014 to cover people earning up to 138 percent of the federal poverty level. That’s around $32,500 for a family of four. West Virginia now has one of the strictest eligibility policies, limiting the program to households with children at up to 35 percent of the poverty line or around $8,240 for a family of four.

As a result, half of the West Virginians on Medicaid are blind or disabled.  Nearly 20 percent are children, while a slightly larger portion is seniors.  But West Virginia still has the 12th-largest Medicaid program among the states when measures as a percentage of its population, with around 330,000 residents covered according to federal figures.  

Teressa Brown said her adult daughter would be among those gaining coverage through expansion. With two pre-school sons on Medicaid, the daughter is an assistant manager at a Kanawha County dollar store. The $8.50 an hour she earns puts her above West Virginia’s current cutoff, the elder Brown said.

Her daughter’s employer offers health benefits, but the premiums would take too much out of her paycheck, Brown said. Speaking through tears, Brown addressed Tuesday’s press conference. Her daughter was home sick.

“I am begging for Gov. Tomblin to help us,” Brown said.

When the U.S. Supreme Court upheld the overhaul, it ruled that states could choose not to expand and not lose current federal funding as the law had threatened. As of Tuesday, 22 states and the District of Columbia have signed on to the expansion and 14 states have rejected it.

The West Virginia Hospital Association supports Tomblin’s approach, spokesman Tony Gregory said. Medicaid reimburses providers at rates below the actual cost of services, though hospitals recognize the benefit of increasing the ranks of those with some sort of coverage, Gregory said. In 2010, his group’s members reported providing $279 million in uncompensated charity care, to those unable to pay, and another $463 million in bad debt where the hospital unsuccessfully tried to collect payments.

“Expansion should occur only after there’s thoughtful analysis conducted by policymakers and stakeholders to make sure the state has the programmatic, operational and fiscal capacity to appropriately do so as the federal funding for the program decreases,” Gregory said Tuesday.

State Senate President Jeff Kessler supports expansion, and believes the pending analysis will support that move.

“I would be shocked if it doesn’t reveal that the simple math of it is that zero state dollars for three years and on the outside ten percent is not cheaper than the current Medicaid rate that we pay of 28 percent,” the Marshall County Democrat said. “So, what’s going to happen if we don’t sign up, these folks are still going to get sick, they’re going to go to emergency rooms and get uncompensated care that we all pick up anyway.”

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