A Republican plan to cut hundreds of millions of dollars from food assistance and health care programs for low income Americans to make way for tax cuts would have “devastating” results in West Virginia, advocates and providers say.
The U.S. House of Representatives early Thursday passed a budget bill that analysts say would cut Medicaid by at least $716 billion — the largest in the program’s history — and cause roughly 15 million people to lose their health care coverage over the next few years.
The bill, which has yet to be approved by the U.S. Senate, would also cut the Supplemental Food Nutrition Program by $300 billion through 2034 and push a portion of the cost of the program to the states to backfill.
Both West Virginia Reps. Riley Moore and Carol Miller, R-W.Va., voted in support of the bill, which narrowly passed with a 215 to 214 vote.
Kelly Allen, executive director of the West Virginia Center on Budget and Policy, said the bill breaks a lot of promises made by Congress and President Donald Trump.
“It does, in fact, enact deep cuts to Medicaid and SNAP that will result in eligible people losing those benefits. It will raise grocery prices and health care costs for tens of thousands of West Virginia families,” she said. “And despite all that, it still increases the deficit, and that’s because it extends huge windfall tax cuts that primarily benefit the wealthiest households in America.”
“Overall, this package just feels like a really bad deal for West Virginians,” she said.
In West Virginia more than 500,000 people rely on Medicaid or the Children’s Health Insurance Program for their health coverage.
The bill adds work reporting requirements, primarily for the expansion population — those that are on the program as a result of the Affordable Care Act expanding coverage to low-income households, Allen said. It also requires more frequent renewals, where participants are revaluated for eligibility in the program.
The work reporting requirements and the more frequent determinations would result in an estimated 50,000 West Virginians being kicked off the health programs, despite continuing to qualify for coverage, she said.
“The vast majority of West Virginians on Medicaid are either already working or likely would meet an exemption because they’re doing caregiving, they’re in school, they’re disabled,” Allen said. “But just because what we’ve seen in other states who have tried this is that overwhelmingly, people who do qualify get kicked off because the new requirements are confusing, burdensome and difficult to follow.”
The bill also adds co-pays up to $35 per Medicaid service and reduces retroactive eligibility from 90 days to one month, which would lead to hospitals in the states absorbing more uncompensated care, Allen said.
The changes are estimated to cost West Virginia about $200 million per year in federal health care money that go to the state’s hospitals and providers, Allen said.
“We know hospitals will see less revenue, and instead they’ll see more of a need for uncompensated care,” Allen said. The loss of revenue will result in an estimated loss of 2,000 to 3,000 health care jobs in the state, she said.
Laura Jones, executive director of Milan Puskar Health Right, a free and charitable clinic in Morgantown, said the Medicaid cuts would have a “profoundly negative effect” on the communities the clinic serves.
“We will have, once again, many people who lack health insurance,” Jones said. “And while there are six free clinics in the state in somewhat strategic locations, there are many areas of the state where options for people without insurance are limited or nonexistent.
“People will resort back to using the emergency room for primary care, which is by far the most expensive way to provide care,” she said. “Wait times at emergency departments will increase, and hospitals will be overwhelmed with uncompensated care yet again.”
Jones’ comments came during a virtual press conference about the Medicaid cuts Thursday hosted by the health care advocacy organization Protect Our Care. The group urged West Virginia Republicans Sens. Shelley Moore Capito and Jim Justice to vote against the cuts when the Senate considers the legislation.
“Medicaid is a lifeline for West Virginia families, seniors, people with disabilities, low income adults and children,” Lynette Maselli, state director of Protect Our Care, said during the press conference. “Today, nearly one in three West Virginians rely on Medicaid for their health care. Cuts to the program mean fewer doctor visits, fewer life saving prescriptions, and more families forced to choose between paying rent and affording care for providers. It means more uncompensated care, lower reimbursements, job losses and potentially even closures of medical centers.”
The bill does not extend tax credits put in place under the Biden Administration that have helped approximately 50,000 West Virginians pay for their health care on the health insurance marketplace established by the Affordable Care Act. The tax credits are set to expire at the end of the year. Allen said the tax credits expiring is likely to mean 15,000 state residents will lose their health care because plans are no longer affordable.
“I think West Virginia would be among the state’s most impacted, because we have the highest health care prices in the country,” she said. “So those subsidies have made a huge difference in helping make prices more affordable.”
States would pick up some costs of the SNAP food assistance program
The federal government has historically covered the entire cost of SNAP benefits, which help approximately 277,000 or one in six West Virginia residents get access to food. The state splits the cost of administering the program with the federal government.
Under the bill that passed the House Thursday, the federal government would shift between 5 to 25% of the cost of SNAP benefits to state governments beginning in 2028. The amount a state pays would depend on its payment error rate.
West Virginia would pay up at least $28 million and up to about $141 million, depending on the error rate, according to an analysis from the Center on Budget Policies and Priorities.
“[$141 million is] more than West Virginia spends on child care, CPS workers and the Promise Scholarship combined,” Allen said. “There’s not a lot of flexibility in the state budget right now as we’ve seen. That almost certainly means state lawmakers would have to raise taxes, raise revenue or cut SNAP or other things that are currently being paid for through the state budget.”
West Virginia Sen. Jason Barrett, R-Berkeley, chair of the Senate Finance Committee, said he’s been in contact with the state’s congressional delegation about what the end product of the legislation will look like. Barrett said it appears the federal government will shift some of the cost of SNAP to the states, but the final bill may not have quite as big a hit to states as the bill left the House.
“The Legislature would have to decide whether we want to continue to fully fund SNAP at the rate that it currently is, or if we want to make some changes as well,” Barrett said.
“No one likes to see federal dollars reduced to the state. I understand that,” he said. “But at the same time, we have to expect our federal government to get its fiscal house in order. Our national debt has increased dramatically over the past couple of decades. While a lot of states may see reductions from federal money, we as a country have to get a better grip on federal spending.”
In addition to shifting the costs to the states, the proposal would expand a current work requirement for SNAP recipients. With some exceptions, able-bodied people up to age 54 who receive food benefits are required to work 80 hours a month or face a time limit on receiving SNAP assistance. Under the bill, those work requirements would be required through age 64. Parents of children age 7 and above, with some exceptions, would be subject to the work requirement.
An estimated 80,000 West Virginia residents become subject to the work requirements or live in household with someone who does, Allen said.
Amy Wolfe, executive director of the Charleston soup kitchen Manna Meal, said the cuts to food assistance would be devastating to the people her program serves. Wolfe estimates that at least 80% of Manna Meal clients get SNAP benefits. Her program helps families fill in the gaps that the SNAP program does not cover, she said.
“Millions of families could lose access to healthy foods that literally we need,” she said. “These are the foods that we need to thrive, and we’re going to cut that? I mean, we’re talking children, seniors, people with disabilities, people without stable access to health care because of the Medicaid cuts — all of our local economies will be affected.”
The bill also eliminates funding to SNAP-Ed, the educational arm of the SNAP program. In West Virginia, SNAP Ed supports the West Virginia University Extension program. Kristin McCartney, public health specialist and director of the SNAP education programs with WVU Extension, said the cuts would decimate staffing for the extension service, which currently has 40 staff educators in addition to administrative staff.
“There would probably only be enough funding for potentially, like half of that,” she told West Virginia Watch.
The West Virginia Democratic Party condemned Moore and Miller’s support for the bill, calling the legislation “a massive tax giveaway to the ultra-wealthy that slashes essential services for working families across West Virginia.”
In the statement, party vice chair Teresa Toriseva called the bill “a disaster for West Virginians and a betrayal of the very people Moore and Miller were elected to represent.”
Amelia Ferrell Knisely contributed to this story.
This story has been updated with comments from West Virginia Senator Jason Barrett.
This article originally appeared on West Virginia Watch.
“West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.”
