Medicaid in the Mountain State: A Health and Economic Necessity

Introduction

West Virginia’s Department of Health and Human Resources (DHHR) is the state’s largest agency with an essential mandate: protecting the health and well-being of our residents. In addition to leading the state’s public health infrastructure, the agency oversees health coverage for 584,000 residents and manages food assistance programs for 150,000 families and temporary cash assistance programs for 5,800 individuals. The DHHR also oversees the state’s child welfare system in a state with one of the highest percentages of out-of-home placements in the country.

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This report will analyze the DHHR’s budget and responsibilities for the fiscal year 2022 (FY 2022), primarily focusing on the functions and administration of the Medicaid program. West Virginia faces significant health needs, including an addiction epidemic, ongoing impacts of the pandemic, a stubbornly high poverty rate, and an aging population with high chronic disease rates among both the elderly and the non-elderly. As such, the state’s health agency is tasked with a broad mission and administration of many vital programs. State and federal investments in the DHHR impact health and the ability of residents to work, go to school, and thrive, as health has such a significant impact on other basic needs.

Key Findings

• Medicaid is the health insurer of one in three West Virginians. It covers half of births, health coverage for over 50 percent of children, and 76 percent of long-term care costs.
• Medicaid is both an expenditure and an essential source of revenue for our state’s budget. Federal dollars comprise 70 percent of the total Medicaid budget, bringing critical funds into the state’s health care system and economy.
• West Virginia has one of the most generous Federal Medical Assistance Percentage (FMAP) rates of any state, pulling down an average of five federal dollars for every dollar that the state spends on the Medicaid program.
• Medicaid supports 25,000 jobs and $5.7 billion in direct and indirect economic activity annually.
• The Bureau for Medical Services, which administers Medicaid, is understaffed by 20 percent; streamlining administrative and enrollment and renewal processes can help in addition to hiring more staff.
• Flat budget projections, tax cuts, and other policies harm Medicaid’s ability to reach vulnerable populations, both in the short and long term.