Doing the math: what repealing the Affordable Care Act would mean for WV

At the risk of being a downer, I feel the need to point out what’s at stake for West Virginia in the latest effort on the part of the president (and the state attorney general) to kill the Affordable Care Act in court.

Spoiler: a lot.

Let’s start with recovery from addiction and mental health. Back in 2017, state officials said that the ACA, and particularly Medicaid expansion, helped bring treatment for addiction to 50,000 West Virginians. That number has no doubt gone up since then.

Recently, Lori Kersey reported in the Gazette-Mail that low-income West Virginians got $90 million worth of mental health and substance abuse treatment last year and almost $300 million over the last four years.

She cited data from the state Department of Health and Human Resources that the state’s expanded Medicaid program provided around $58 million in mental health and substance abuse treatment in 2015. It increased to $61 million in 2016, $79 million in 2017 and $90 million in 2018.

I’ve talked with people who are convinced that access to that treatment saved them from death or worse and brought them back to the land of the living. Now they’re clean, putting their lives together, taking care of their children, holding down jobs and paying taxes.

As Jesus said in one of his most famous parables, “be glad for this, your brother was dead, and is alive again. He was lost and is found.” (Luke: 15:32)

Now imagine all that gone.

Then there’s this: According to the DHHR, as of April 1 of this year, 160,356 West Virginians were covered by Medicaid expansion, a state option under the ACA. Most of these people are holding down jobs. Another 22,600 state residents bought coverage under the ACA exchange. Then there are around 12,000 young people in the state who can stay on their parent’s insurance until age 26, another ACA provision.

Then there’s the fact that the ACA helped reduce prescription drug “donut hole” costs under Medicare Part D for the approximately 240,170 West Virginia seniors who participate in the program. The icing on the cake is the fact that the ACA brings hundreds of millions of dollars to our economy, creating thousands of jobs and helping to keep rural hospitals and health care providers going.


The Urban Institute has estimated that repealing the ACA could result in the loss of 16,000 jobs and $9.1 billion in state economic impact.

Imagine all those dollars and jobs, too.

Then remember that those are just the numbers, but behind the numbers are real people, families and friends, people we know, work with and love.

Screwing over that many people of all ages with one stroke would be quite an accomplishment, even by today’s standards.

It would be the next worst thing to a natural disaster of biblical proportions, except the harm would be caused by the deliberate action of a handful of people.

If it comes to that, I don’t think it will be forgotten anytime soon.

(This appeared as an op-ed in today's Gazette-Mail.)