April 18, 2025

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.)