The elderly, veterans, indigent adults, almost all children and disabled people already have health insurance, he noted. "If you're in jail, you're covered," he said. "But many working people are not."
An estimated 236,000 West Virginia adults between 19 and 64 -- one in five -- have no insurance, according to the West Virginia Division of Insurance. Six in ten are from working households.
In 2014, an estimated 170,000 West Virginians will be eligible for health insurance through Medicaid under the new law, Medicaid Commissioner Nancy Atkins told the conference. Many will be children transferred from the Childrens Health Insurance Program, but adults who earn up to 133 percent of the federal poverty level will also be eligible, she said.
Starting in 2014, another estimated 125,000 West Virginia adults with higher incomes can shop for subsidized health insurance through the insurance exchange, according to Division of Insurance preliminary estimates. A family of four earning up to $88,000 will be able to buy subsidized insurance through the exchange, Stoll said.
The federal government will pay 100 percent of the cost of the new Medicaid enrollees till 2020, under the reform law. Thereafter, the state would have to come up with 10 percent of the cost.
Manchin, who is running for the U.S. Senate, told the conference the tobacco tax could be increased specifically to pay the 10 percent cost. "It's time to do that," he said.
According to a 2008 West Virginia Health Care Authority study, the state will save more than $200 million a year in uncompensated health care costs after hundreds of thousands are newly insured. "Right now we're paying hidden costs of unnecessary emergency room visits," Manchin said.
All speakers said the state has much work to do before the major parts of health care reform kick in, in 2014. "It's no longer a fight in Washington, D.C.," Stoll said. "The work is in the states now."
Atkins reeled off a long list of tasks Medicaid must accomplish while getting ready. "But it's an exciting time to be in health care," she said.
The conference, titled "Growing Healthy Children: Health Care Reform Summit" is funded by the Claude Worthington Benedum Foundation, with support from the AARP, West Virginia CHIP, and a variety of statewide health groups, governmental and private.
The conference continues Tuesday at the Charleston Marriott.
Reach Kate Long at (304) 348-1798 or katel...@wvgazette.com.