CHARLESTON, W.Va. -- A report on how West Virginia could expand Medicaid has already cost the state more than $860,000 and was due in January, but its focus has changed and it's now expected in May.
The Charleston Daily Mail says officials are now calling their revised goals for the report an "internal planning document" that contains sensitive information and cannot be made public.
At the request of lawmakers, the administration hired Maryland-based CCRC Actuaries to study the feasibility of a health-care exchange, or a publicly run market where people can seek competitive prices for insurance. Exchanges are part of the federal overhaul of health-care regulations.
Gov. Earl Ray Tomblin announced in February that West Virginia will partner with the federal government for its exchange, instead of running one on its own or leaving it entirely to the U.S. government to operate.
But Tomblin has yet to say whether the state will open the Medicaid program to more lower-income residents, or how individuals and small businesses will seek coverage.
The federal law calls for states to offer Medicaid to adults with unadjusted annual household incomes of up to 138 percent of the federal poverty level. That's a far higher income level than West Virginia currently allows, and amounts to about $31,800 for a family of four. An estimated 130,000 West Virginians would gain coverage.
But while upholding the overhaul last year, the U.S. Supreme Court struck down its threat to withhold a state's existing federal Medicaid dollars if a state refuses to expand its rolls.
About 415,000 West Virginians received health-care services through Medicaid during the past budget year. West Virginia has the 12th-largest Medicaid program when measured as a percentage of a state's population.
CCRC Actuaries has completed some work, but not its assessment of expanding Medicaid.
Jeremiah Samples, health policy director for the state insurance commissioner, says the original contract didn't include a completion date, and the goals have changed since it was awarded. But he won't say how they've changed.
Samples said CCRC had expected to finish its report by Jan. 31, but private insurers were reluctant to share information, and that delayed their work. He now expects the project to be done by May.
The federal government will cover the costs of expanding Medicaid for three years, but states must pay 10 percent of the costs by 2020. Medicaid already consumes much of the state budget, and Tomblin has cut spending in other areas to compensate for rising costs.
Twenty states and the District of Columbia have indicated they will expand coverage, while another four are expected to, says public policy company Avalere Health LLC. Ten states will likely opt out, and 15 have formally declared they won't participate.Avalere says West Virginia is the only state that has not indicated which way it's leaning.