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By Bob Weaver
Medicaid was created 38 years ago to provide health care to the nation's most vulnerable people. Half the recipients are
children, most of the rest are pregnant women, the elderly and the disabled. One of every six West Virginians depends on
Medicaid for their health insurance.
The Medicaid program is in deep trouble in West Virginia and the nation. As West Virginia's economy lost 35,000 jobs last
year, mostly to foreign relocation, 11,000 more people in West Virginia qualified for care.
Gov. Bob Wise wants to raise the cigarette tax to 55 cents a pack, otherwise more than $240 million would have to be cut
from next year's Medicaid budget. It is likely to pass the legislature. The measure will bring some temporary relief to the
program, with cuts still looming. .
Medicaid cuts have already bankrupted or closed several mental health centers in the state, including the largest center in
Charleston. Mental health services are seriously lacking in West Virginia.
Medical care is also at risk with many rural hospitals and low-income clinics on the edge of insolvency. Three-quarters of the
hospitals in the state lost money on patient care last year, according to the West Virginia State Hospital Association.
Critical are services like Minnie Hamilton Health Care Center which provides lots of care to an under-served rural area.
Cut reimbursements to hospitals, and they could stop delivering babies, or shut down entirely, said DHHR's Paul
Nusbaum. If the state makes it more difficult for people to qualify for Medicaid, more uninsured people will show up in
emergency rooms, sicker than they would have been before, he said. That ends up in cost shifting to insurance.
"All we're talking about is shifting the cost of their health care onto the private sector," Nusbaum said. "If we don't stop, no
one will be able to afford private insurance at all."
The head of Blue Cross/Blue Shield told a legislative committee last year it
will cost over $16,000 a year for family coverage by 2006. Currently, it is not uncommon for individuals to pay $7,000 to
$8,000 a year for private insurance.
But if the cigarette tax fails to pass this year, Medicaid likely will cut payments to hospitals and doctors by 15 percent,
according to Nusbaum.
Many programs that prevent sickness could end up on the chopping block, such as health fairs and school-based clinics.
West Virginia spends about one-third of its Medicaid budget on so-called optional services, including prescription drugs, and
vision and dental care.
Additionally, West Virginia has a high number of uninsured people, not eligible for Medicaid or Medicare, and many others
who are seriously under-insured.
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