Some W.Va. lawmakers wary of expanding Medicaid

CHARLESTON, W.Va. (AP) -- Several members of a House-Senate oversight committee questioned West Virginia's decision to expand Medicaid under the federal health care overhaul on Monday, after fielding details from the financial analysis that helped prompt Gov. Earl Ray Tomblin to choose that course in May.

Conducted by CCRC Actuaries with the help of specialists, the study estimates that 91,500 low-income West Virginia would gain coverage starting next year, by increasing the income threshold for enrolling in Medicaid. The analysis also concluded that more than $5 billion in promised federal funds would cover nearly all resulting costs over the next decade.

The analysts believe West Virginia has enough willing health care providers, but Delegate Denise Campbell isn't so sure. The Randolph County Democrat and nursing home administrator cited her time both as a nurse working in doctors' offices, and how Medicaid reimburses for medical care at a lower rate than private insurance.

"I live in rural West Virginia, and I know how long it takes to see a doctor," Campbell said. "They do limit the amount of Medicaid patients that they do take... I, in my heart of hearts, really feel like we're going to have a provider issue here. Are these people going to be able to have access? Are there going to be enough providers to provide the service?"

Sen. Evan Jenkins expressed similar concerns. The Cabell County lawmaker is executive director of the State Medical Association, which lobbies for physicians. Though a Democrat, Jenkins has also been touted as a potential Republican candidate for Congress in 2014.

"A provider may say, 'I take Medicaid,' but the question is, what is the breadth of that taking?" Jenkins said.

Jenkins questioned other provisions of the federal overhaul, including the eventual mandate that virtually all Americans carry medical insurance. He cited figures from the analysis that estimate that insurance premiums will soar for younger adults, depending on the level of benefits. That stems from language in the law that prevents insurers from charging older people, who tend to have more health needs, more than three times what they charge younger people. The current ratio, also known as a rating band, is seven-to-one, the committee was told Monday.

"Bottom line, we have some pretty significant, quote, winners and some pretty significant losers with the implementation," Jenkins said.

The analysis found that that expanding Medicaid while following other provisions of the federal health care law eventually will reduce the ranks of the state's uninsured from 246,000 West Virginians to around 76,000. Besides improving health care outcomes, in a state that ranks at or near the bottom for obesity, heart disease diabetes and other chronic ailments, the overhaul will also help ease the annual burden or charity and uncompensated care now borne by hospitals by an estimated $20 million to $30 million, the study said.

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