WV Legislature Medicaid Update

The West Virginia regular legislative session ended on March 9.  While the session had its share of controversy, three bills supported by West Virginians Together for Medicaid were sent to the Governor’s desk:

SB 546 – expanding Medicaid and Children’s Health Insurance Program (CHIP) coverage to low-income, uninsured pregnant women up from 163% to 300% of the federal poverty level (fpl). Prenatal care, delivery, and 60 days postpartum care are covered.  Before SB 546, Maternal and Child Health Block Grant money paid for some pregnancy coverage up to 185% fpl.  These funds can now be diverted to pay for other needed services for families.

HB 2405 – places a tiered assessment on all Health Care Maintenance Organizations (HMOs) in order to “permit the maximization of federal matching dollars for use in the state Medicaid program.” All HMOs operating in the state are subject to the assessment except PEIA (state-employee plans), FEHBP  (federal employee plans), and Medicare Advantage plans. The assessment will sunset in three years. The assessment rate would be based on a per member per month basis and is higher for Medicaid member months than for nonMedicaid members.  The revenues raised go into a Medicaid dedicated fund and will pull down federal matching dollars. WV receives at least $2.99 in federal funds for every state dollar spent on Medicaid.

HB 2010 – About 80% of the WV Medicaid population is enrolled in Medicaid Managed Care Organizations (MCOs) and CHIP is transitioning to managed care.  This bill transitions the foster care child population to a single MCO and will eventually transition all families at-risk of an out-of-home placement of a child to the same MCO.  The purpose of the transition is to enhance overall coordination of services, ensure continuity of care as a child moves through the system, and enhance linkages between medical and social services. The bill also has other provisions to improve the WV foster care system, including to:  1) create a foster care ombudsman; 2) require DHHR to enter into performance-based contracts with child placing organizations; 3) require a study of kinship care; 4) extend the time a foster care certification is authorized; 5) require that a home safety assessment takes place annually; 6) sets rules regarding removal of a child from a residential child care program; 7) prohibits the termination of parental rights when the parent participating in a medically assisted treatment program; and, 8) establishes rules about when a foster child can be placed in an out-of-state facility.

In addition, West Virginians Together for Medicaid opposed HB 3136 to create a work requirement in the Medicaid program.  The bill died in the House. Although Medicaid work requirements have been defeated two years in a row, we expect to see a Medicaid work requirement initiative again in 2020.

Thank you to all who made calls to the legislature to express their support of the Medicaid program and to share their personal stories of how Medicaid has made a positive difference in their lives. 

West Virginians Together for Medicaid