"The major hold up is the actuary analysis," Bryant said. "I thought doing the analysis was due diligence and understanding the cost and benefits was the correct way to go. We were told early in January, then late January and now late March before it's publicly released.
"The delay has been disappointing," he said.
If Tomblin moves forward with expansion, the state's Medicaid officials need to outline essential health benefits that would be offered to the state's Medicaid population.
That's no easy task, and time is short. Enrollment in Medicaid and the state's health insurance exchange begins in October, Bryant said.
"Any time you deal with benefits it's a tough issue," he said. "There's a conflict between wanting a rich product and rolling down cost. You want meaningful public input."
Opponents have also argued that Medicaid expansion would create too many new patients for the state's doctors to handle and physicians won't accept them all.
But a significant portion of the uninsured that would qualify for Medicaid under the expansion are already being treated at the state's 27 community health centers, said Louise Reese, CEO of the West Virginia Primary Care Association.
In 2011, those centers served 379,702 patients -- 91,000 of which were uninsured, according to the latest data available, Reese said.
Many of them will qualify for Medicaid under the expansion, though the exact number isn't known, she said.
Community health centers receive federal and state money to care for any patient regardless of his or her ability to pay. That money doesn't always cover all of the costs for the uncompensated care, Reese said.
"It's a fine balancing act using other resources to be sure they have the assets to cover the uninsured," Reese said.
While officials wait on word from Tomblin, community centers are identifying their uninsured patients and making sure they have accurate contact information for them, Reese said.
That way, they'll be ready to contact those patients and walk them through the process of finding out what they're eligible for -- be it Medicaid or a plan through the state's health insurance marketplace.
"Health centers will play an important role as the marketplace exchange is implemented and Medicaid expansion," she said.
Other agencies will also be helping the uninsured people find out what they're eligible for, she said.
Health centers want to continue to serve that population if Medicaid is expanded.
"[Health centers are] very adept about providing care coordination and managed care for certain populations," Reese said. "So we understand the Medicaid population well and we know we can do a good job treating them."
Reach Lori Kersey at lori.ker...@wvgazette.com or 304-348-1240.