Story by Kat Skeldon, MetroNews

CHARLESTON, W.Va. — Amid nearly one-third of West Virginians relying on Medicaid, the state-federal affordable healthcare insurance program could face over a $100 million dollar shortfall if lawmakers don’t act.

State healthcare experts met on Monday morning in Charleston advocating for West Virginia legislators to vote to preserve and protect Medicaid in the state just in time for Medicaid Awareness Month.

Monday’s press conference included remarks from the Executive Director of West Virginians for Affordable Health Care, Ellen Allen, West Virginia Rural Health Association Executive Director Rich Sutphin, and Health Policy Analyst Rhonda Rogombe with the West Virginia Center on Budget and Policy.

Their aim is to encourage lawmakers to pass a fully-funded Medicaid program when they are expected to meet again in May.

Ellen Allen

Allen said right now, the current deficit for Medicaid is about $79 million. However, she said as federal Covid relief funding expires, which has been plugging holes in the state budget related to Medicaid, the shortfalls are only set to worsen.

“Moving forward for fiscal year 2025, we’re looking at a $179 million deficit, and that’s just state dollars, because it’s a federal and state partnership, for every dollar West Virginia puts in, the federal governments put in three,” Allen said.

During the past regular legislative session, lawmakers passed a budget of $4.997 billion in general revenue for FY 2025, $226 million less than what the governor originally proposed.

According to the West Virginia Center on Budget and Policy, multiple crises have already begun to emerge within entities such as Child Protective Services, public schools, and correctional facilities due to several years of essentially “flat” budgets being passed in the state.

Allen said while Medicaid is not in crisis yet, the potential failure to pass sound public policy for it would make it become a crisis.

“The only way it would become a crisis is if lawmakers fail to act in May,” said Allen. “That’s a crucial time, they have the ability to fund this fully, and also to ensure those federal dollars come back into the state, I mean, where do you get a better investment than three to one.”

She said Medicaid covers healthcare costs for about 564,000 people in the state, including low-income earners, senior citizens, and people with disabilities and children, and without it, they risk not having any other source to turn to.

On top of that, Allen said Medicaid also serves as a major economic driver throughout communities, helping to fund hospitals, healthcare providers and clinics, among other medical and health-related services.

“It reimburses hospitals, because so many people depend on it, they go to their hospital, they go to their healthcare provider, those providers count on the Medicaid reimbursement, without it they wouldn’t be able to deliver those services, and in rural communities, it’s even a greater usage,” Allen said.

West Virginia Rural Health Association Executive Director, Rich Sutphin said and as West Virginia is a largely rural state, Medicaid it the state’s largest healthcare program.

He said half of the one-third of West Virginians benefiting from Medicaid are children, so it’s crucial more funding goes into the program for their sake.

“If we’re looking at the future of our state and the future of rural health in West Virginia, we have to think of our kids,” Sutphin said. “Making sure that Medicaid continues to be a strong program in West Virginia is really important to making sure we have a vital state and a vibrant population for our future.”

Allen said during the press conference that a total of 53% of children, and 76% of nursing home residents are covered by Medicaid.

However, Health Policy Analyst Rhonda Rogombe said in 2020, the federal government paused renewals for the Medicaid program which started the unwinding process last year.

She said after just wrapping up that process and looking at the data, over 180,000 residents have now lost their healthcare coverage.

“Some of those folks have gone to other sources like employer-based coverage or the Affordable HealthCare Marketplace, but there are a lot of unknowns and a lot of people who are simply uninsured in our state right now,” said Rogombe.

But, through increasing awareness of the issue, Allen said they feel lawmakers will turn it around when they go back to session.

“We think if people really understand the significance of it, that they will want to fund this, the governor had enough money in his budget and we’re hoping that that will be restored,” said Allen.

West Virginians for Affordable Health Care plans to use this April’s Medicaid Awareness Month to highlight four key issues:

. Week of April 1: Medicaid is Working

. Week of April 8: Women and Children

. Week of April 15: Substance Use Disorder

. Week of April 22: The Unwinding