One of the most hotly debated topics in the United States government is healthcare, specifically as it relates to Medicaid regulations and expansion. With the advent of the Affordable Care Act (ACA) several years ago and increased pressure from the public to create a health insurance plan for all low-income individuals and families, the federal government has had its hands full. To complicate matters, each state has the power to decide which parts of Medicaid to expand, if any. One state that has expanded Medicaid but has a complicated relationship with the policies of the ACA is West Virginia.
Current State of West Virginia Medicaid
West Virginia has indeed chosen to expand Medicaid for its citizens according to federal regulations. This means that any household making less than 138 percent of the federal poverty line (FPL) can be eligible for government healthcare assistance. Since the ACA was implemented, many residents of West Virginia have signed up for Medicaid and left behind private plans from the Marketplace, making for a 46 percent decrease in private insurance enrollment between 2016 and 2020.
However, the battleground topic that is Medicaid is not an easy one to navigate for any state. This is especially true now due to budget cuts that have reduced many of the capabilities and allowances of the ACA, causing funding to be limited. One aspect of Medicaid that’s difficult in West Virginia is that free or low-cost bronze healthcare plans that other states have are not currently available to West Virginians.
Medicaid has definitely given many people the opportunity to have healthcare coverage who wouldn’t otherwise have access to it. However, this issue of plan availability, along with many others, means that the situations of many patients and the healthcare organizations treating them are still not as good as they could be.
West Virginia and the ACA
As federal government officials have been progressively working to undo and/or replace ACA legislation, many states have been doing what they can to cling on to ACA regulation. They have done so by passing new state laws that bolster what other lawmakers have changed or removed.
However, West Virginia has done little to maintain the policies of the ACA for its citizens. In fact, state officials have been actively working against it. Lawmakers of several states, including West Virginia, have done this by filing a series of lawsuits under the thesis that the ACA is unconstitutional. At the same time, the West Virginia government has been trying to create its own healthcare plan, called the West Virginia Healthcare Continuity Act, to prepare in case the ACA is repealed at some point. Progress of these lawsuits and this new legislation are ongoing and will be worth keeping track of.
How DECO Can Help
We make it a priority to stay up-to-date on current healthcare regulations, and Medicaid is just one of many that we keep track of. We do this so that we can be educated about patients’ eligibility for insurance and how these programs are affecting hospital billing and revenue cycle management. If you would like more information, we have also developed an ebook resource that details how each state has responded to Medicaid expansion. Contact us today with any questions you may have!