February 05, 2020

At the WV legislature, not all bills are bad...really

It’s encouraging that some positive health-related bills and policies seem to be moving at the state Capitol.

One huge advance was announced in December, when Gov. Jim Justice directed the West Virginia Department of Health and Human Resources to study options for eliminating the waiting list for the Intellectual and Development Disabilities Waiver, or I/DD, program.

This program allows individuals with special needs to receive care in their homes and communities, rather than an institutional setting, a policy that makes sense both in terms of human needs and budget savings.

While the state has had this program for a good while, many eligible people, mostly children, weren’t getting the services they need.

Over 4,800 West Virginians were participating in the program as of November 2019. However, over 1,000 people, mostly children, have been on a waiting list to receive services, some for over four years.

That’s some good news. More could be on the way:

HB 4416 would build on legislation passed last year that extended Medicaid coverage for 60 days postpartum for women between 138 percent and 185 percent of the federal poverty level. This year’s proposed legislation would extend that coverage to a full year.

That’s a big deal, because the maternal mortality rate has been increasing in recent years. Last year, West Virginia Public Broadcasting reported that “American women are three times more likely to die during or after birth than women in Great Britain, and eight times more likely than women in Scandinavian countries.”

Fortunately, West Virginia’s rate is lower than the national average, but still, 15 women died in the first year after giving birth in 2018, with eight of those deaths related to substance use, according to Beckley’s Register-Herald. Extending coverage for a year could help ensure services for substance use disorder, postpartum depression and other complications.

SB 648 would provide dental coverage to adults on Medicaid. The bill was introduced by Sen. Tom Takubo, R-Kanawha, with several Republican co-sponsors. Oral heath goes way beyond toothaches, which are bad enough. According to the Mayo Clinic, oral health could contribute to conditions such as endocarditis (an infection of the inner lining of heart chambers), cardiovascular disease, pregnancy and birth complications, and pneumonia — all of which are way more expensive than a trip to the dentist.

Then there’s one that strikes close to home for me: HB 4543, which would cap insulin costs for West Virginians with type I and II diabetes.

My daughter was diagnosed with type I diabetes when she was pregnant with my grandson. Type I is a very scary autoimmune disease apparently caused by environmental and genetic factors unrelated to things like diet and exercise. As if that weren’t enough, my grandson was diagnosed with the same disease in middle school.

Both are very athletic and diet-conscious. My daughter has earned a black belt in karate and run several ultra-marathons. My grandson is a champion golfer.

Even with that, dealing with Type I is like having a full-time job that wants to kill you. I’d take heart disease any day.

The lifeline is insulin, which is needed just to maintain life for as long as the patient lives. Different diabetics require different kinds of insulin, and the costs can be astronomical. For my daughter and grandson, the costs of a refill that lasts for five or six weeks is $849.75.

That’s with health insurance and discount cards.

They’re not alone. According to the proposed legislation:

It’s estimated that over 240,000 West Virginian’s are diagnosed and living with type I or type II diabetes and another 65,000 are living with one of those conditions but haven’t been diagnosed. Every person with type I, and many with type II, require insulin to live.

Medical costs associated with diabetes in West Virginia are estimated to be $2.5 billion.
People with diabetes typically incur medical costs around 2.3 times higher than people without the disease.

The cost of insulin has increased astronomically, especially the cost of insurance co-payments, which can exceed $600 per month, not counting other necessary equipment and supplies.

According to national reports, as many as one in four type I diabetics underuse, or ration, insulin because of these increased costs. Rationing insulin has resulted in nerve damage, diabetic comas, amputation, kidney damage and even death.

It doesn’t have to be that way. Recently, a group of West Virginians with diabetes took a bus trip to Canada to buy insulin. Prices there are about one-tenth of what they are here, because that nation controls the price of pharmaceuticals to ensure that the price of medicine isn’t excessive and remains comparable with prices in other countries.

The proposed West Virginia legislation would do the same.

This lifesaving bill enjoys bipartisan support and has been championed by House Health and Human Resources Chairman Jordan Hill, R-Nicholas, and Delegate Barbara Evans Fleischauer, D-Monongalia.

Taken together, these measures could help a lot of West Virginia families. I’d like to see them cross the finish line.

(This appeared as an op-ed in the Charleston Gazette Mail.)

No comments: