CHARLESTON, W.Va. -- Gov. Earl Ray Tomblin has not decided whether West Virginia will expand its Medicaid program under federal health reform, Medicaid Commissioner Nancy Atkins said Wednesday.
About 120,000 uninsured West Virginians stand to gain health insurance if the state expands its program as prescribed by the federal law. State officials are "having discussions on this question every day," Atkins said.
In June, when the Supreme Court ruled the Affordable Care Act constitutional, they also surprised West Virginia officials by ruling that Washington cannot take away all of a state's Medicaid funding if a state refuses to expand coverage to people who earn up to 133 percent of the federal poverty level, as prescribed by the law.
At 133 percent of the federal poverty level, an individual earns $15,000 and a family of three earns about $26,000.
"We're talking mainly about working poor people -- people who work for small employers who can't afford health insurance," said Perry Bryant, executive director of West Virginians for Affordable Health Care.
Atkins and Bryant were among about three-dozen health officials attending a monthly health reform roundtable sponsored by WVAHC.
"If we don't do the expansion, we'll be leaving a lot of poor people unserved," Atkins said, "so we are sifting through the questions and numbers. These are not simple questions."
West Virginia Medicaid insures primarily children. Parents who earn up to 35 percent of the federal poverty level qualify. Childless adults do not.
Kathleen Stoll, Deputy Executive Director of the national health advocacy group Families USA, said via speakerphone, "Medicaid expansion is a very good deal for West Virginia," because the federal government pays 100 percent of the cost for the first three years and 90 percent thereafter.
The Republican governors of Texas and Florida have said they will not expand their programs. "It would be fiscal malpractice to turn away hundreds of millions of dollars and leave people uninsured," Stoll said.
According to the Congressional Budget Office, the Medicaid expansion would add only 2.8 percent, on average, to the amount states already pay for Medicaid, she said, but it would substantially reduce the amount of unpaid emergency room and hospital bills. "The savings will balance the costs," she said.
"We need an actuarial analysis that includes both costs and savings," Bryant said.