State lawmakers and Governor Patrick Morrisey touted improving health as a major priority during the 2025 state legislative session. But while several themes emerged that will be highlighted in this piece, legislation that would have significantly moved the needle on health failed to pass. At the same time, many policy proposals are happening at the federal level that could push additional health-related costs and responsibilities onto the state, potentially deeply impacting the state budget, grants available to state agencies, and hundreds of thousands of residents across the state.
Two bills that advanced through the Senate would have improved infant and maternal health outcomes in West Virginia: SB 292 would have extended access to doula care for Medicaid and PEIA enrollees, while SB 482 would have established expanded access to midwifery by providing Certified Professional Midwives a path to licensure. Both bills represented cost-efficient means of improving birthing outcomes across the state and play an important role in combatting racial and health disparities experienced by families across the state. Doulas and midwives achieve these outcomes by decreasing the number of unnecessary c-section births and low-birthweight births, as well as improving post-birth mental health outcomes and breastfeeding uptake. Both bills passed the Senate unanimously, but did not make it over the finish line in the House.
Legislators did not introduce as many bills aimed at rolling back Medicaid, SNAP, and other critical programs for working class families this year as they have in recent years, though several did make an appearance. One of these was a bill that would significantly cut the Medicaid program. This bill would have eliminated the Medicaid expansion—or taken West Virginia back to pre-Affordable Care Act levels, taking health care away from 166,000 working-class West Virginians—if the federal match rate for Medicaid dropped at all. Currently, the federal government pays for 90 percent of costs for this population, which has helped states that implemented the program ensure the wellness of their constituents. After broad pushback from advocates, providers, impacted people, and lawmakers on both sides of the aisle, the bill was moved to the inactive calendar where it died.
Several bills aimed to cut substance use recovery programs despite their efficacy.[1]
Furthermore, there were several bills aimed at curbing access to food, such as requiring photo identification on electronic benefit transfer (EBT) cards and mandating the SNAP employment and training (E&T) program, which is currently voluntary. These bills did not pass. While photo identification would be expensive to implement and impossible to enforce, mandatory E&T programs have not improved employment in areas where they have been implemented but decrease food accessibility.
Lawmakers also introduced and debated several bills seeking to lower vaccine requirements in the state, which is a priority of Governor Patrick Morrissey. West Virginia currently has among the best vaccination rates of any state, largely due to our stringent vaccine requirements. The bill that made it the furthest in the legislative process, Senate Bill 460, would have allowed broad religious exemptions for childhood vaccinations. Others aimed to prohibit mandates or allow philosophical exemptions for public school aged children.[2] These bills did not pass, but the Governor’s office is now in the process of enacting these exemptions via executive order, though it remains to be seen if that is lawful.
Vaccines play a crucial role in public health by teaching the immune system how to respond to a range of infections and illnesses. When communities are vaccinated, they are less likely to contract and spread diseases such as measles, polio, the flu, and other potentially life-threatening conditions. In 2019, the United States had over 1,200 cases of measles despite being considered eliminated in 2000; the uptick is directly related to fewer vaccinations.
Aligned with national and state trends over the past several years, the Legislature also dedicated much of the session on limiting gender affirming care. These policies included striking down exemptions on gender affirming care for minors, prohibiting public schools from acknowledging a student’s gender identity and from teaching about gender identity and sexual orientation, and legally defining gender as binary. Each of these bills have been signed into law. None of these policies improve health outcomes for trans and queer West Virginians. In fact, limiting trans West Virginians’ ability to express themselves and their gender identity could lead to poorer health and life outcomes, as they increase their likelihood of experiencing anxiety, depression, and other mental health concerns.
Despite many of the threats to the safety net dying as sine die approached, the fight is not over. The federal government is seeking deep cuts to safety net programs, particularly Medicaid, over the next decade, potentially removing access to health care and food for millions of families across the nation. Though it is unclear exactly how Congress will approach these cuts to Medicaid, proposals include work reporting requirements, copays and premiums, lifetime caps on benefits, and decreasing federal contributions to these programs. Each of these shift responsibility from the federal government to the state or individual, who must find ways to mitigate the harm of these policies. And each of these could result in up to 166,000 West Virginians losing their care, over one billion dollars fewer circulating the health economy in the state, and thousands of jobs lost.
Legislators and impacted communities alike must push back against harmful cuts to the safety net as there will be major implications for the state budget and services available. Take action here.
[1] HB 3306, 3385, SB 867.
[2] Senate Bill 49, House Bill 2004, House Bill 2954.
