Saving Medicaid: in their own words

 While going through some old files, I came across a copy of an interesting letter dated June 29, 2017, from then Governor, now Senator, Jim Justice to Senator Shelley Moore Capito. The subject was the looming threat of the repeal of the Affordable Care Act (ACA) and especially Medicaid expansion.

Here are some excerpts:

Since so many of our people count on Medicaid, any cut to Medicaid would destroy families in West Virginia. We can’t put the 175,000 West Virginians who benefit from the Medicaid expansion at risk of losing coverage. The consequences would be beyond catastrophic.

In the face of our drug epidemic, fewer people would have access to drug treatment programs under the current proposal. As the debate moves forward, I hope you and your colleagues will consider the fact that it will only make it harder to combat the drug problem that’s ravaging West Virginia.

I think he nailed it then—and his words still apply today, arguably more than ever.

To her credit, Senator Capito issued this statement on July 18 of that year:

As I have said before, I did not come to Washington to hurt people. For months, I have expressed reservations about the direction of the bill to repeal and replace Obamacare. I have serious concerns about how we continue to provide affordable care to those who have benefited from West Virginia’s decision to expand Medicaid, especially in light of the growing opioid crisis. All of the Senate health care discussion drafts have failed to address these concerns adequately.

My position on this issue is driven by its impact on West Virginians. With that in mind, I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.

I think she nailed it too.

Eight years later, we’re facing a similar threat. This time around, the issue isn’t directly repealing the whole ACA, although it might as well be. Instead, it’s a federal budget reconciliation package that would cut $880 billion from Medicaid (not to mention $230 billion in SNAP food assistance and $12 billion in school meal funding) to pay for more tax cuts for the very wealthy.

A cut that huge would truly be, as Justice said, beyond catastrophic across the US and especially in low-income states like West Virginia. Our already dismal health statistics would get worse. Minor issues will turn major. Substance use disorder will go untreated. The cost of emergency room visits and uncompensated care will grow and be passed on to others. Rural hospitals will close. Jobs will be lost. And people will die.

The margins in Congress are razor thin. Our senators’ votes could influence the final outcome, especially after the House voted to throw us under the bus. I hope they take their own advice and side with the people of West Virginia again.

(This appeared as a column in the Charleston Gazette-Mail.)

Budget bill a disaster for West Virginia

 The US House of Representatives recently voted on a proposed budget that would cut $880 billion from Medicaid and $230 billion from SNAP food assistance while also slashing other programs, including meals for school children…to give $1.5 trillion in tax cuts aimed mostly to benefit the very wealthy.

The measure passed by just a two-vote margin. Both of West Virginia’s representatives voted for it. 

If this becomes law, the damage done to West Virginians across the board would be incalculable. 

Medicaid alone provides health coverage to over 72,000,000 people nationwide and to more than 500,000 West Virginians, including working adults, children, seniors, pregnant women, people with disabilities, and people getting treatment for substance use disorder. That’s close to one out of three of us. 

We’d be hit harder by this than most other states. Nationwide, one out of five people are covered. It’s almost double that in West Virginia.

According to the Kaiser Family Fund, as of August 2024, around half of all childbirths are paid for by Medicaid here, while nearly the same percentage of children are either covered by it or the Children’s Health Insurance Program. It’s the major source of people needing long-term care, including 7 out of 9 people in nursing homes. It provides benefits for 40 percent of people with disabilities.

And while it covers many people who are too young or no longer able to work, most adults receiving it are employed.

The funding, most of which comes from the federal government, supports local economies, keeps rural hospitals open, and keeps people alive. It’s no exaggeration to say that if this goes through, people will die as a direct result. And people would lose their jobs.

If that wasn’t enough, the budget would reduce SNAP food assistance to 42 million people. As with Medicaid, we’d take a disproportionate hit here as well. Our state ranks third highest in the percentage of SNAP households, just behind New Mexico and Louisiana. Nationally, around 12 percent of people receive SNAP, while it’s 16 percent here.

According to the Food Research and Action Center (FRAC), SNAP helps 124,000 households here, or 279,000 individuals. It brings over $40 million a month to the state, helping 2,170 grocery stores and farmers markets and creating jobs. It’s estimated that each dollar’s worth of SNAP spending generates around $1.80 in economic activity.

Households receiving SNAP include children, the elderly, people with disabilities, and veterans. As with Medicaid, most SNAP households include at least one working member. And if you’re worried that these people are living high on the hog you can relax. The average daily benefit here is $4.54 per person.

On top of all that, the budget bill cuts $12 billion in funding for school breakfasts and lunches and makes sweeping restrictions to the Community Eligibility Provision (CEP), which supports meals for all. FRAC estimates this will reduce access to food in 24,000 schools with 12 million students. 

In West Virginia, we’re talking about impacts in 468 schools with over 180,000 students. This would undo years of progress at the national and state level. CEP has proven very popular in every county in West Virginia since it cuts bureaucracy, improves child nutrition and educational outcomes, removes stigma, and gives working families a break.

The combined impact of these proposed cuts would hurt people across all political and demographic lines. Fortunately, it’s not a done deal. There will be more votes on this over the next few months.  This could give time for people to voice their concerns and for lawmakers to reconsider their actions. 

It’s important to also urge our senators to put the brakes on this. To her credit, Senator Capito said back in 2017 “I didn’t go to Washington to hurt people,” when huge health care cuts were on the agenda. As governor, Jim Justice expanded food aid to low-income children when school was not in session and established the Jobs and Hope program.

Before it’s over, I hope at least some of our representatives will put the people of West Virginia above all else.

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