This morning Governor Earl Ray Tomblin announced his decision to exercise the state option under the federal Affordable Care Act to expand Medicaid to 138% of the federal poverty level.  West Virginia was one of the few remaining states to announce a Medicaid expansion decision. 

Governor Tomblin emphasized in his remarks that he was most focused on three issues: fiscal responsibility, Medicaid enrollee responsibility and administrative efficiency.  He acknowledged concern over the federal government’s ability to sustain its financial commitment in the future and stated clearly that the state reserves the right to reevaluate eligibility criteria if necessary.  He also stressed that the expansion would include co-pays to promote better health care decision making and utilization on the part of the enrollee.  He said there would be a new push for expanded participation in managed care within the Medicaid program. 

In reaching his decision, Governor Tomblin relied heavily on a state commissioned actuarial analysis from CCRC Actuaries.  The ‘Medicaid Expansion Report’ was given to the Governor on April 16 detailing the anticipated expansion costs.  Key findings of the report include:

·         Medicaid expansion will provide insurance coverage to approximately 91,500 West Virginians

·         Coupled with other ACA mandates, the number of uninsured West Virginians will drop from 246,000 to 76,000 by 2016

·         Medicaid expansion costs for West Virginia will be approximately $375.5 million from FY 2014 through FY 2023

·         Expansion results in approximately $5.2 billion in federal dollars coming into the state from FY 2014 through FY 2023, or an average of $520 million per year over the 10 year period

To view the Governor’s press release announcing his decision and a PowerPoint presentation detailing the issues he considered in making his decision click here.