08 Apr W.Va. to Lose $16.2B Under GOP Plan, Group Warns (WV)

April 8, 2011

By: Lawrence Messina
Source: The Associated Press

CHARLESTON, W.Va.— Among the states most dependent on Medicare and Medicaid, West Virginia stands to lose $16 billion over the next decade under a Republican plan for the federal budget, a health care advocacy group said Thursday.

Seniors and people with disabilities are the most at risk, Families USA warned. Deputy Executive Director Kathleen Stoll estimated during a Wednesday interview that between half and two-thirds of the state’s Medicaid budget covers nursing home, community-based and in-home care for these people. Around 40,200 West Virginia seniors receive these and other Medicaid services that Medicare does not provide, the group said.

“If West Virginia continues its Medicaid program, they will have about 33 percent less federal support to do that program,” Stoll said. “That is beyond dramatic. It’s extreme and radical.”

But supporters of the measure say it tackles rising costs in both programs as part of a long-term plan to curb government spending. The GOP-led House could pass the proposal as early as next week, Stoll said.

More than 17 percent of West Virginia’s 1.8 million residents rely on Medicaid for health care, the 12th highest share among states, according to the latest available U.S. Census Bureau figures. The figures from Families USA estimate that West Virginia’s program would take a $12.8 billion hit between 2012 and 2021, losing enough that final year to cover 270,200 children and 52,000 seniors.

The estimate includes $7.7 billion meant to expand Medicaid access starting in 2014 as mandated by the federal health care overhaul. This could prove critical because West Virginia’s program now has among the strictest eligibility standards. It virtually excludes poor, working-age adults unless they have children or are pregnant or disabled. Slightly over half of state residents on Medicaid are younger than 18.

Families USA supported the federal overhaul’s passage. The budget proposal embraces the GOP’s goal of repealing it. As reflected in Thursday’s estimate, the Republican plan would also eliminate $3.1 billion in tax credits for people who buy private coverage through the federal law’s health insurance exchange provision. West Virginia’s Legislature approved creating a state-run exchange during the recently completed regular session.

West Virginia draws down around $2.80 in federal Medicaid funds with every dollar it provides from its own revenues. The new state budget that kicks in July 1 includes $2.05 billion in federal funds for Medicaid — an amount roughly equal to half the main, general revenue portion of the budget. The federal proposal would convert Medicaid into a block grant program, giving each state a lump sum to design its own insurance plans. Stoll called that approach “really off the radar screen extreme.”

“No matter what happens here in West Virginia — if you have floods in the south, if you have a harder-hitting recession — and your enrollment rose, you would not be able to pull down federal dollars to keep what you have now,” Stoll said.

We st Virginia has the nation’s largest portion of residents on Medicare, nearly 22 percent of its population, according to census estimates. The proposed changes to that health care program for seniors would be far more gradual.

More immediately, the GOP plan would repeal the federal overhaul’s provision erasing the “doughnut hole” gap in Medicare prescription drug coverage. But it would keep the overhaul’s scaled back payments to the program’s private insurance option, Medicare Advantage, Stoll said.

Starting in 2022, new retirees would get fixed amounts of money from the government to buy private insurance. Families USA did not estimate West Virginia’s share of the resulting cuts. But the nonpartisan Congressional Budget Office said Wednesday that future retirees would pay considerably more for health care under this proposed approach.

“Each year (after 2022),

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