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Editorial: Benefits of Medicaid expansion outweighed the potential costs

May. 05, 2013 @ 10:20 PM

In deciding to loosen West Virginia's tight restrictions on the state's Medicaid program, Gov. Earl Ray Tomblin made the right call.

Taking into account a variety of factors, the governor announced Thursday that the state will expand Medicaid under the controversial federal health care reform law that goes into full effect on Jan. 1.

The chief result is that an estimated 91,500 state residents who now have no health insurance will have the opportunity to get coverage, based on an income qualification that is far more reasonable than it is now. The federal law urges states to extend Medicaid benefits to people who make less than 138 percent of the federal poverty line. That's about $32,499 for a family of four.

West Virginia now has one of the strictest limits in the country, prohibiting adults from enrolling if their household earns more than $8,240 for a family of four. People in that situation had no hope of meeting basic needs and still purchasing health insurance -- let alone paying any significant health care bills that might come up. It's no wonder that loosening the requirement means that tens of thousands more people can now qualify.

Another compelling argument is that many West Virginians are in dire need of medical care. A recent audit commissioned by Tomblin noted that the Mountain State ranked 48th among states for overall health care outcomes, and was the worst for obesity, diabetes, adult smoking and heart disease deaths. Beyond that, there is the high percentage of residents who need treatment for addictions to drugs and alcohol. There's no question West Virginians need to pay more attention to their health, and extending Medicaid coverage to many more of them will help them do that.

The expansion won't come without a cost to the state budget, an analysis ordered by Tomblin showed. That study estimated that West Virginia's support of Medicaid will increase by $375 million over the next decade under the expansion. The bulk of the increased costs will be borne by the federal government, to the tune of about $5 billion over that same span.

The study also cited other benefits for expanding coverage. The state's hospitals will save an estimated $20 million to $30 million a year annually in uncompensated care provided now to the uninsured. The move also will take some pressure off many employers, who must decide whether to provide health insurance for their employees or pay a penalty to the government. By expanding Medicaid, many of their employees will have another avenue to gain insurance and the employer won't have to pay a penalty. That could mean a savings to them of anywhere from $6 million to $18 million a year, the study said.

Many Republican officials are critical of Tomblin's move, arguing that health care reform -- or Obamacare, as it's widely called -- will hurt the state and national economies. That, of course, remains to be seen.

But the fact remains that health care reform is the law of the land. West Virginia, based on its residents' relatively low income levels and the poor health of so many, has a greater need than most states for extending insurance coverage to more people. Should so many of its residents be deprived for the sake of making a political point?

Tomblin said "No" to that question, and it was the correct answer.



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