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Medicaid Increases Volume, Quality of Care in Rural Areas

A new study led by a Boston University School of Public Health researcher Megan Cole finds the first two years of Medicaid expansion under the ACA, 2014 and 2015, bolstered the quality and receipt of care for millions of low-income patients, especially those in rural areas.

The study, published in the June issue of Health Affairs, looked at community health centers, which mostly serve low-income and disproportionately uninsured patients. The researchers found community health centers in expansion states saw an 11.44 percentage point decline in uninsurance, compared with similar community health centers in non-expansion states. Rural community health centers also showed improvements in asthma treatment, body mass index screening and follow-up, and hypertension control, along with substantial increases in 18 types of visits—particularly for mammograms, abnormal breast findings, alcohol-related disorder, and other substance use disorders.

At rural community health centers, Medicaid expansion was associated with approximately 437,000 visits for depression, 141,000 visits for Pap testing, and 457,000 visits for hypertension over the two-year period.

Community health centers in rural areas also saw improvements over their non-expansion counterparts in several treatment areas, including a 3.5 percentage point increase in patients with asthma receiving appropriate pharmacologic treatment, and a a 6.7 percentage point increase in adults receiving a BMI screening and follow-up if needed. The researchers also found a 2.1 percentage point increase in blood pressure control for hypertensive patients, with the greatest relative gains in this area seen among Hispanic patients in rural areas, who had a 5.2 percentage point increase.

The authors wrote that they may not have seen an association between more visits and Medicaid expansion at urban community health centers because patients in urban areas have greater access to other providers, whereas rural patients have fewer choices and so are more likely to continue going to a community health center when they gain insurance coverage.

“Hopefully policymakers are attentive to the fact that scaling back eligibility could reverse these important gains,” Cole says.

Share Your Story - Op-Eds and LTEs - Just Do It!

If you are reading this and you rely on Medicaid, consider Sharing Your Story through this website. Our new Story Collection Coordinator, Lara Foster, will follow up with you privately and talk with you about opportunities to share your story publicly. She can help you write your story or present it to others.  You will control how and when your story is used to educate the public and law-makers.

Another way to share your story is by writing an Op-Ed (Opinion Editorial) or LTE (Letter to the Editor) and sending it to your local paper. Our Op-Eds and LTEs – Just Do It fact sheet can help you draft and submit your own Op-Ed or LTE. West Virginians Together for Medicaid is about bringing the voices of individuals in our state who rely on Medicaid forward to educate the public and lawmakers. With one-third of West Virginians enrolled in Medicaid at some time during a year, the program is a life-line for family, friends, and neighbors. If you live in West Virginia, you know someone on Medicaid – even if you don’t realize it.

We are at a defining moment in our country as more and more people rely on Medicaid for affordable, quality health care even as opponents push out ugly misperceptions about the program and the people who rely on Medicaid. We are seeing Medicaid threatened with funding cuts and harmful changes again and again. To save Medicaid, it is critical that we showcase the human stories of individuals and families benefiting from the Medicaid program – low-income children, pregnant women, people with disabilities, seniors, families with a loved-one who needs long-term care, and people who work lower-wage jobs with no health benefits. 


What the Heck is a Medicaid SUD 1115 Waiver?

Funny wonky name, huh? Here's the answer:  The West Virginia Medicaid Substance Use Disorder (SUD) 1115 Waiver gives our state a set of new tools to fight the opioid addiction crisis confronting our rural communities. The federal Secretary of Health and Human Services can let states deviate from certain Medicaid rules when necessary to implement demonstration projects (also called section 1115 waivers) that further Medicaid’s core objectives, including improving coverage or beneficiaries’ health outcomes.  Following guidelines developed by the Obama Administration, West Virginia was the first state to submit and be approved for a SUD 1115 waiver. The waiver allows West Virginia to cover critical SUD treatments and services with federal Medicaid matching dollar by: 

OpEd: Disability is a Natural Part of the Human Experience

Paul Smith, long-time West Virginia advocate for the rights of people with disabilities, has worked closely with WV Together for Medicaid to protect the program from federal and state attacks and funding cuts.  His OpEd today in the Charleston Gazette addresses the right of people with disabilities to live independently and productively.  Medicaid pays for critical supports that help people with disabilities stay in their homes and live in the community.  West Virginia has made progress eliminating and shortening waiting lists for these services - but more funds are still needed. And remember - for every $1 the state invests in Medicaid, the federal government provides $2.9 in matching funds.

"....Who of us without a disability would ever choose to live our adult life in a segregated group setting where we make no choices about where we live, who lives with us, or what our own daily activities will be?

For West Virginia to regress to any form of institutional care, whether it be in a large group home or a segregated community, is inhumane treatment of vulnerable individuals.

Institutional care is, ironically, often proposed by well-intentioned individuals as the safest option possible; but, in fact, it has always eventually resulted in being the worst and most dangerous option. West Virginia should work harder to see that supports to succeed at home or on the job are appropriate and meet the individual needs of people with disabilities....

To take any steps backward in this day and age is unimaginable and would be a tragic loss for all West Virginians. With waiting lists for Waiver services, no new funding to address them and increased funding for institutional services, we must change direction. We must move forward, not backward.

We must ensure that the civil rights of individuals with disabilities are protected; that people are not placed in settings that isolate them from the broader community; that individuals have choices, have control over their own lives, are integrated in and have full access to the greater community...."

Free or Low-cost Breast Cancer Screenings and Treatment in WV

3.5 million women in the United States are living with a history of breast cancer. Approximately 1 in 8 women will be diagnosed with breast cancer during their lifetime. In 2018, there will be an estimated 266,000 new cases of female breast cancer and 40,920 deaths attributable to breast cancer, according to a new fact sheet on breast cancer screening and prevention from the Kaiser Family Foundation.

Breast cancer is the most common cancer among West Virginia women, making up almost 25% of all female cancers. The majority of breast cancers are found in women; however, it does occur in men. Getting a routine breast cancer screening is the best way to lower your risk of dying from breast cancer. Screening can help find cancer at an early state when treatment is most effective. For more information about breast cancer, check-out

The West Virginia Breast and Cervical Cancer Screening Program provides free or low-cost breast and cervical cancer screening and diagnostic services for eligible women in West Virginia. To be eligible for the Program, a woman must be a West Virginia resident between the ages of 25 and 65 years, be uninsured or underinsured, and be at or below 250% of the federal poverty level ($30,350 income per year for 1 person; $51,950 income per year for a family of 3). Women who are diagnosed with breast or cervical cancer through the Program may be eligible to receive treatment through West Virginia Medicaid. For more information about the Program call 1-800-642-8522 or visit

Neighbor State Virginia to Expand Medicaid

Our neighbor state of Virginia looks to be finally ready to follow in the footsteps of West Virginia and expand Medicaid to more low-income adults without health insurance.  Virginia's expansion will cover as many as 400,000 low-income people.  West Virginia expanded Medicaid back in 2014. Virginia will become the 33rd state, along with Washington, DC, to expand Medicaid under the Affordable Care Act (Obamacare). 

The Senate voted today, May 30th, to approve a budget that will allow the Medicaid expansion. The House had already voted in favor of the expansion but will have to vote again before the bill can go to Governor Northam (D).  The Governor supports the expansion and has made it a priority for his administration. Virginia will rely on provider taxes to fund the cost of the expansion.

Many of us in West Virginia are thrilled to see our neighbors in Virginia take this important step forward. 


Op/Ed: Remember How the US House Wanted to Gut Our Health Care?

Nancy Tyler, health care consultant and West Virginians for Affordable Health Care board member, lays out the last year in health care in a new op/ed in the Charleston Gazette.

Montana HELP-Link: A Model for West Virginina to Move Medicaid Enrollees to Good Jobs

President Trump is promoting work requirements in the Medicaid program. In our blog on May 15th, we highlighted a couple of new resources that explain how a Medicaid work requirement could harm many West Virginians who rely on Medicaid. The Montana HELP-Link program provides an alternative to a mandatory work requirement that actually helps Medicaid enrollees receive the training and education that helps them move into jobs with decent wages that lift them out of poverty.  

Medicaid Work Requirements: Harm to Women

Mother’s Day made me think about how Medicaid is a critical source of health coverage for women. But coverage for many women in West Virginia – and across the country - is at risk due to recent actions by President Trump and his administration. A new federal Medicaid guidance for the first time allows states to take away Medicaid coverage from people who do not work a certain number of hours each week. This work requirement can be imposed on adult Medicaid enrollees up to age 65, and to many women who care for children or older family members at home. A new Center on Budget and Policy Priorities Policy Brief explains more, and a West Virginians for Affordable Health Care Frequently Asked Questions Fact Sheet provides insight into why a Medicaid work requirement is not necessary in our state and will result in more uninsured West Virginians.

Medicaid Matters to Moms

Anna Jarvis, Mother’s Day creator and West Virginia native, was deeply involved in the health of her family and her own mother’s primary caregiver. Anna Jarvis established Mother’s Day to honor her mother, and to honor all women who daily advance the health and well-being of their families, neighbors, and communities.

Health insurance coverage is key to women’s access to health care, overall health, and economic stability. Thanks to the Affordable Care Act (ACA), millions of women across the country who did not have health insurance before are now able to get affordable, quality coverage through Medicaid.

In West Virginia, the Affordable Care Act Medicaid expansion implemented in 2014 gave tens of thousands more women the peace of mind knowing that they had insurance coverage and would be able to see a doctor for check-ups and health care.

West Virginians for Affordable Health released a Mother's Day Fact Sheet highlighting the ways Moms rely on Medicaid.

West Virginians Together for Medicaid