How more than 48,000 West Virginians could lose health care coverage


By: Ellen Allen

February 22, 2024

The facts are simple: Medicaid is facing a $114 million shortfall; however, Medicaid is not in crisis.  Unless the failure to pass sound public policy makes it one. 

There has been a lot of discussion recently surrounding Medicaid and its impending financial shortfall, and even more information being thrown at us regarding possible solutions. Some which are mostly disinformation and hype from out-of-state entities.

Medicaid is the state’s largest health insurance program — and at a projected federal/state budget of more than about $5.2 billion. It supports not only West Virginia residents but also the health care infrastructure through more than $4 billion in federal matching dollars.  Medicaid is a major economic force. 

West Virginians for Affordable Health Care (WVAHC) continues to champion a one-time, supplemental appropriation to cover the $114 million deficit — the first request of its kind in nearly 10 years. However, some lawmakers and right-leaning, out-of-state “think tanks” advise cutting services, and one strategy to do this is by enacting additional work requirements. 

There is no evidence that work requirements improve the well-being of our citizens.  They actually throw thousands of people off Medicaid making healthcare unaffordable and out of reach. 

One bill under consideration requires reporting a certain number of hours worked per month, such has been implemented in Arkansas: Data from Arkansas’ ten-month implementation of its policy and brief implementation in Michigan and New Hampshire provide direct evidence of these policies’ harmful effects.

  •  In Arkansas, more than 18,000 people — nearly 1 in 4 of those subjects to work requirements — lost coverage over the course of just seven months. 
  • In New Hampshire, almost 17,000 people, or about 40 percent of those subject to work requirements, would have lost coverage had state policymakers not put the policy on hold. 
  • Some 80,000 Michiganders — nearly 1 in 3 of those subjects to work requirements — were in danger of losing coverage had a court not stopped the policy.

 It is noteworthy that while 12 states in the past received approval to enact work requirements - policies unlikely to receive approval today - were ultimately blocked by the courts  and none are currently in effect . Enacting such policies would cost the State of West Virginia hundreds of thousands of dollars–if not millions– in legal fees fighting court challenges.  This is not sound or ethical stewardship of resources. 

In all three states, evidence suggests that people who were working and people with serious health needs who should have been eligible for exemptions, lost coverage or were at risk of losing coverage due to red tape. Taking coverage away from people not meeting work requirements also increases financial hardship and reduces access to care. 

Based on these failed experiments in other states, it can be projected that between 48,000 and 95,000 West Virginians will lose healthcare coverage if additional work requirement policies are enacted. The economic hit to The Mountain State would be a whopping $277M to $487M in lost federal dollars.

Additional work requirements and other barriers to enrollment in Medicaid will not help West Virginia’s economy or improve the health of the state’s population, which is already one of the unhealthiest in the nation. 

Moreover, such cuts, for example, could include slashing Medicaid reimbursement rates to hospitals, physicians, nursing homes and other providers. In turn, that would significantly reduce access to needed care if providers are unable to continue to furnish the same level of services to Medicaid beneficiaries, no longer take Medicaid beneficiaries or cease operations entirely.

West Virginians for Affordable Health Care urges lawmakers to preserve and protect Medicaid, and not to fall prey to the misinformation circulating about Medicaid and its recipients. It is essential to West Virginians and is a necessity to the state’s economic and health outcomes:  All the data currently available demonstrates that the benefits associated with an investment in community health are vast and enduring.