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.

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CHARLESTON, W.Va. -- West Virginia is taking strong steps to get ready for the new federal health-care reform law, Kathleen Stoll, deputy director of the non-profit Families USA, told a conference of West Virginia health-care workers, policy-makers and advocates Monday.

"I go all over the country, and I would rank West Virginia in the top 10 states in terms of thinking ahead and doing the things that need to be done," she said, speaking at the "Growing Healthy Children" conference in Charleston.

"West Virginia has a real head start on many states," Mark Blum, director of America's Agenda: Health Care for All, agreed.

Conference attendees provided examples:

| All West Virginia community health centers have applied for and received federal stimulus grants to expand and improve their physical facilities. Most are adding staff with health-reform dollars. "We're getting ready for many thousands more patients," state Primary Care Association director Louise Reese said.

| In 2009, West Virginia applied for and got a $36 million federal grant to help design an online insurance marketplace and expand the state's use of electronic technology to make care less costly and more efficient. "That grant puts us far ahead of the curve," Perry Bryant, director of West Virginians for Affordable Healthcare, said.

| The state Bureau for Public Health secured funding to work with local health departments to upgrade their operation and get ready for the new system. "The landscape is shifting, and community health centers, health departments, hospitals, are all finding their best roles," said Joe Barker, who directs the Office of Community Health Systems.

"West Virginia also faces unusual challenges," Blum said. Health care costs 13 percent more in West Virginia than the national average, he noted, and 80 percent of the state's health-care costs are associated with chronic disease, "alarming rates of juvenile diabetes, stroke, heart disease, and hypertension."

Health-care premiums rose four times faster than wages in West Virginia since 2000, Stoll said.

"We have been touted as the most unhealthy state in so many categories, and we know we can do so much better than that," Gov. Joe Manchin told the conference earlier in the day. "The jury is still out on what the final result will be, but we can't stay where we have been and get results."

The new law will primarily benefit working people, Manchin said. "Working people are the main vulnerable group we have out there," he said.

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.