CHARLESTON -- It's a late Thursday afternoon, and Martha Walker has just finished her umpteenth conference call addressing the sprawling federal overhaul of the nation's health care system.

As Walker explained to lawmakers a few days earlier, these phone sessions have become a recurring feature of her work schedule: at least three a week with other members of a National Governors Association task force, and a separate batch for a multistate coalition of agencies expected to carry out the changes. There are four or five other conference calls a week, and Internet-based "webinars" as well.

"Everybody is sort of feeling their way along," Walker told The Associated Press on Thursday. "The answer to a lot of our questions is, 'We're not sure about that yet. We'll track that down and get back to you.' It's all so new."

Walker is acting director of the Governor's Office of Health Enhancement and Lifestyle Planning, or GOHELP. The Legislature created the agency last year partly to help the state implement any health care changes that might emerge from Congress.

"We're not necessarily the subject matter experts on any of these things. We're here to coordinate," Walker said.

But that alone appears to be a daunting task. The health care legislation clocked in at over 900 pages, Walker noted. Its numerous provisions will require U.S. Health and Human Services Secretary Kathleen Sebelius to issue more than 100 different sets of rules.

Then there are the looming deadlines: June 21 for setting up the temporary high-risk pools meant to cover those uninsured because of pre-existing medical conditions; July 1 for a state-specific website explaining the revamped health care choices to consumers; and Sept. 23 for initial insurance market changes.

"The law is extremely complex with significant changes to existing programs and many new programs," Walker told members of the House-Senate Select Committee on Health last week. "As you might expect, these initiatives present opportunities and challenges for us collectively."

Those challenges include costs. Insurance plans, for instance, must begin extending coverage to policyholders' children until they reach 26. For programs such as the state's Public Employee's Insurance Agency, that's expected to increase annual policy costs by $3,380 per dependent starting with the coverage year that begins July 1, 2011.

West Virginia's hospitals, meanwhile, have told Walker that reimbursement rates from federal health care programs will plummet by a combined $1.2 billion over the next decade. Her office has scheduled the first of several planned public forums to field such concerns June 14 at Davis Memorial Hospital in Elkins.

Other challenges include ensuring there are enough doctors, nurses and other providers in the state for the expected increase in newly covered residents. Sen. Ron Stollings, D-Boone and a physician, noted during the legislative interim meeting that 47 of 55 counties are considered medically underserved.

"I cannot recruit a primary care physician to Madison, W.Va., at this time. I have tried," Stollings told Walker.

But Walker's new agency may give West Virginia an edge over other states as they all grapple with the overhaul. Besides that key mission, its other goals include promoting healthy lifestyles, harnessing the latest technology for patient medical records and pursuing medical homes.

The latter envisions a single physician or clinic overseeing a patient's entire care, and developing programs to address such chronic conditions as diabetes and hypertension. Such goals would complement the overhaul purpose of the federal health care changes, Walker said.

And while the overhaul's fine print may be new to Walker, the underlying themes are not. Walker, 70, was Gov. Joe Manchin's Health and Human Resources secretary before he picked her for this post. Her resume also includes serving as the state Senate's health committee chair.

"Everybody wants (the overhaul) to be instantaneous, but you really have to proceed a step at a time. You've got the build the framework," Walker told AP. "As we wade through this, there will be things that work and there will be things that don't. But the concept, what they're trying to accomplish, is a good thing."

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Lawrence Messina covers the statehouse for The Associated Press.

Online:

W.Va. GOHELP: http://www.gohelp.wv.gov

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