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In early March, Sen. Shelley Moore Capito looked into the camera and told anyone watching that she wouldn’t kick any West Virginians off Medicaid. 

“I want to make sure that our benefits are still there for that 500,000 people,” Capito told WCHS.

For his part, Sen. Jim Justice told Axios last month that he had concerns about cuts to Medicaid, which serves nearly 30% of the state’s population. 

Last weekend, Capito and Justice voted to move along a budget plan that would require $880 billion in cuts over the next decade, largely to Medicaid. 

When offered an amendment to prevent those cuts, the two Republicans voted with their party against it. Had they switched their votes, it could’ve stopped the cuts.

Capito and Justice’s offices did not reply to a request for comment.

West Virginia could lose over half a billion federal dollars under this proposal, according to one analysis released last month. On a per capita basis, the state would have the largest cut in the nation.

And state Republicans have already shown they’re ready to throw thousands off Medicaid if Congress cuts the program.

This is part of a move by federal lawmakers to make President Donald Trump’s 2017 tax cuts permanent. The richest Americans would get a quarter of a million dollars knocked off their tax bills. The poorest 49 million taxpayers would only save $70 on average.

In West Virginia, many people with low incomes and persistent health problems rely on Medicaid to get treated by doctors and receive their medications. Just as many also rely on Social Security and Medicare, a government health insurance program for those age 65 or older.

Trump said earlier this year that none of the three would be touched.

For the last decade, thousands of West Virginians have been able to get health care through the expansion of Medicaid under the Affordable Care Act.

Currently, for every $1 the state chips in for that population, the federal government kicks in $9.

At the end of a routine House Finance Committee meeting late last month, Republican leadership suddenly proposed a trigger law.

If Congress cut federal funding, more than 160,000 West Virginians would be tossed off the Medicaid expansion.

“That was the first time we’d ever laid eyes on it,” said Del. John Williams, a Democrat from Monongalia County.

After another Democrat threatened to bring the House’s work to a standstill, Republicans held a Thursday afternoon meeting to take testimony.

Healthcare advocates told lawmakers that the trigger bill would not only lead to an increase in uninsured West Virginians, but could collapse entire hospital systems.

As quickly as it had been proposed, leadership shelved the trigger bill just days later.

Del. Matthew Rohrbach, a doctor and deputy speaker, said it was a message to Congress. But he’d received word over the weekend that federal lawmakers would not touch that part of the Medicaid program.

“They’ve heard us loud and clear,” said Rohrbach, a Republican from Cabell County.

“That’s not the deal that the states made when we did expanded Medicaid,” he added.

But now those assurances don’t seem so firm. 

In comments to MetroNews this weekend, Capito said she’s seeking for the states – who partially fund the program – to pick up a bigger piece of the tab.

“We hadn’t heard that before,” said Rich Sutphin, executive director of the West Virginia Rural Health Association. 

Health care workers at rural hospitals and clinics rely on Medicaid funding, and he said they were just able to catch their breath after the state’s trigger bill was shelved.

In a hallway outside the House Finance Committee, Rohrbach let out a long sigh. He said if Congress cuts Medicaid, that trigger could come back.

“We’re going to see where it goes,” he said.

Just Thursday morning, the U.S. House approved the federal budget framework, taking another step towards slashing Medicaid.

Reach reporter Henry Culvyhouse at henry@mountainstatespotlight.org