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Rebecca Powers, of Lost Creek in Harrison County, was born into addiction. Now, she works as a cashier and clerk and uses Medicaid to pay for the mental health medication and addiction treatment she needs to live a stable life, visiting her kids and taking care of herself.
She says without it, it’s likely she will lose her job, lose her home, lose visits with her kids and experience a mental health crisis.
“To be honest, that scares me to death,” she said. “I make $9 an hour, hardly enough to live.”
In late February, members of the U.S. House of Representatives passed a budget that would preserve $4.6 trillion in tax cuts the Congress passed with Trump’s support in 2017. The resolution requires members of Congress to come up with $880 billion in savings over a decade and they would have to cut Medicaid to do so. West Virginia’s delegation in the U.S. House of Representatives voted in favor of the budget.
West Virginia’s Riley Moore and Carol Miller voted for the budget, though about 500,000 West Virginians, nearly one in three, use Medicaid to pay for doctor visits, hospitalizations, treatments, screenings and more. The program saves lives by catching dangerous conditions early and paying for life-saving treatments like addiction treatment.
Before Medicaid expansion, the program mainly covered the disabled, the elderly and pregnant women.
The Affordable Care Act gave states the option to use Medicaid to cover more people and the health care services they need. In 2013, then-Gov. Earl Ray Tomblin decided to take advantage of the program promoted by former President Barack Obama and incentivized with additional federal dollars.
Now, it helps many others who can’t afford health care.
Two parents with two kids who are between the ages of one and six are generally eligible for the program if they make less than about $45,000. A single mom with a five year old is eligible if she makes below about $22,000.
Even so, many Republicans have wanted to kill the program.
National and local health care advocacy groups have been sounding the alarm for months that Medicaid cuts were coming, but throughout the session, neither the state Department of Human Services nor lawmakers would talk about specific plans if the federal cuts became reality.
Earlier this legislative session, West Virginia House Deputy Speaker Matthew Rohrbach, R-Cabell, said lawmakers were hesitant to take action since members of Congress hadn’t indicated which parts of Medicaid might be cut.
“But if they do, then we’ll have to deal with it accordingly, but I don’t think we can preemptively do things,” Rohrbach said last month.
But last week, in a House of Delegates committee meeting, lawmakers introduced a bill to cut all of the low-income Medicaid expansion patients from the program, even if the U.S. Senate passes a budget that wouldn’t require such a significant cut. The bill, which stalled Monday, would end Medicaid expansion if the federal government decided to cut any amount of money for the expansion program.
“This is kind of a preemptive thing to send a message to Washington that hopefully they’ll hear loud and clear,” Rohrbach said on MetroNews “Talkline.” He added that lawmakers don’t want federal funding cuts to the expansion program, and he hopes the bill doesn’t need to be enacted.
Jim Kaufman, president of the West Virginia Hospital Association, said cuts to the Medicaid expansion program would affect far more than the 165,000 West Virginians covered by it. Losing patients who rely on the expansion program would hit rural hospitals, like Boone Memorial, Pocahontas Memorial and Roane General, already at risk of closure, the hardest.
They’re not just treating Medicaid patients. Kaufman noted that if a hospital has to close and cut services, everyone who relies on that hospital would lose that service too. That includes people who make more and get their insurance through employers or buy private plans with discounts through the Affordable Care Act.
“That’s what people don’t get,” Kaufman said. “They’re like, ‘Oh Medicaid, I’m not on Medicaid, it won’t affect me.’ It’s everybody.”
Then, he noted, the hospital can’t recruit as many workers because they would be offering less care. That creates an economic ripple effect.
“Then they’re not paying taxes,” he said. “Their salary is no longer being spent at the local grocery store. They’re not buying a local car. That house they were going to buy – they’re not buying that house.”
The state would also lose crucial funds it uses to keep rural clinics open and help people with addiction reach long-term recovery.
Powers, the cashier in Harrison County, used Medicaid for detox and rehab multiple times, because like most people with addiction problems do, she relapsed often.
And treatment providers took her back each time.
Now in recovery, she gets to visit a doctor for check-ups, go to support groups and learn about ways to deal with cravings.
Medicaid money has also allowed treatment providers to give out naloxone to patients.
A patient at a Clarksburg addiction treatment clinic, EJ Drihmi, has used it to save friends’ lives.
He was homeless before a Clarksburg-based treatment program helped him enter recovery. He became an in-home caregiver, making $13 an hour, for people with health problems who need help to safely live at home.
“There’s no way I’d be able to pay several hundred dollars for insurance,” he said.
If the state got rid of Medicaid expansion, Drihmi said he’d likely be homeless again.
Lawmakers were scheduled to begin considering the proposed bill Monday on the House floor. They took it off their calendar, but it could still be revived at any time. But in the meantime, lawmakers have sent health care providers and advocates across the state into a frenzy.
Rich Sutphin, executive director of the West Virginia Rural Health Association, was one of those who rushed to testify at a last-minute meeting of the committee. He said the result would be a catastrophe for rural clinics, often the only health care providers in their community. They need Medicaid money to survive.
Opponents of the bill scheduled an emergency press conference at the Capitol Monday, where some held signs saying “The war on the poor is immoral.” Few lawmakers listened in.
Some other states have passed laws dictating what would happen if the federal government decides to start sending states less money to cover the expansion population.
But other states have also included in those laws mechanisms to prevent people from immediately losing access to care while West Virginia’s version would kick people off the rolls immediately.
When she heard that Republican lawmakers had introduced legislation to end Medicaid expansion, Powers worried for herself and others.
“I’ve seen them, if the person’s insurance dropped while they were in rehab, they just put them out the door,” she said.
And when people lose treatment and health insurance, they’re more likely to overdose and die.
Henry Culvyhouse contributed reporting.
Reach reporter Erin Beck at erin@mountainstatespotlight.org
