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Lawmakers to meet with DHHR on disputed Medicaid figures

CHARLESTON, W.Va. -- State lawmakers plan to meet today with Department and Health and Human Resources officials, after the DHHR allegedly miscalculated the number of West Virginians who might be covered by Medicaid under health-care reform, greatly inflating the cost figures.

Earlier this month, DHHR officials told legislators that if Congress passes a health-reform bill, as many as 260,000 additional West Virginians might be insured by Medicaid by 2019, at a cost of between $25 million to $104 million a year.

House Health and Human Resources Chairman Don Perdue, D-Wayne, said Monday that he and others, including Sen. Dan Foster, D-Kanawha, plan to meet with DHHR officials.

"We asked them to revisit their numbers," said Perdue, who has previously pushed to expand Medicaid coverage. "We think that the assumptions that they started with were wrong, and that led to a rather large ballooning of the cost. ... It could lead to some false assumptions."

Perdue said his staffers believe DHHR's estimate may have doubled the actual cost, after examining the projections. 

DHHR spokesman John Law said officials are "looking at the figures."

The department's numbers were based on the false assumption that 193,000 West Virginians would be eligible for Medicaid if the health reform proposals passed, the Gazette reported last week.

DHHR got the 193,000 figure from a summary of the impact of health reform on West Virginia, prepared by the U.S. House of Representatives Energy and Commerce Committee, DHHR chief financial officer Tara Buckner told the Gazette last week. The 193,000 would become 260,000 by 2019, DHHR projected.

The congressional summary does say health reform would provide 193,000 West Virginians with insurance, but Medicaid would cover only part of them. The rest would buy their own insurance, with or without subsidies.

"I don't know that we'll recalculate [the statistics]," Law said Monday.

Congress has not passed final legislation, he said, so nobody can know exactly what Medicaid expansion will cost West Virginia.

In its report, DHHR cited the Congressional Budget Office as the source of the 193,000 figure. DHHR officials told the Gazette last week that CBO had sent the congressional offices a letter with that figure. Law later called back to correct that statement.

"There is no letter from CBO," he said. Instead, he said, the 193,000 "came from the talking points from the House Committee on Energy and Commerce."

Buckner confirmed Law's statement. "We added up the numbers for the three congressional districts," she told the Gazette.

When DHHR released its projections, Rep. Shelley Moore Capito, R-W.Va., said she was "floored" by the figures.

In November, Capito had asked DHHR to prepare the projections, saying the national legislation could "lead to a troubling unfunded mandate for state governments."

Capito, who voted against the U.S. House's health-reform bill, believes the cost to states is an important issue, regardless of what the numbers are, spokesman Jon Coffin said. 

"Whether the number is A or it is B, it will still be part of the dialogue," he said. "This is something that needs to be talked about. It hasn't been talked about enough. It does push a mandate onto the states, and we need to know what it is."

"We're certainly open to looking at anything new that comes out of DHHR," Coffin said. "The fact remains that, whether it's one number or a different number, this is going to cost something, and we should know what it is."

The U.S. House bill would expand coverage to families who earn up to 150 percent of the federal poverty level. The U.S. Senate version would cover people making up to 133 percent of that level. 

To be eligible, a person would have to make less than $14,400 and a family of four would have to earn less than $29,300.

West Virginia Medicaid currently covers families who earn up to 35 percent of the federal poverty level. Most childless adults do not qualify.

The group West Virginians for Affordable Health Care has asked DHHR Secretary Patsy Hardy to withdraw the report, said Perry Bryant, the group's executive director. 

"It gives the perception that what Congress is doing is prohibitively expensive for the state, and that we ought not to do that, when in fact expanding Medicaid has a number of positive impacts on West Virginia," said Bryant.

Unpaid hospital and emergency room bills would be greatly eliminated, he said, lowering costs for all.

Reach Alison Knezevich at alisonk@wvgazette.com or 304-348-1240. Reach Kate Long at katelong@wvgazette.com or 304-348-1798.

To see the Congressional summary DHHR used for statistics, click here.  

 

 

 

 


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