West Virginia faces unique challenges in the face of the COVID 19 crisis, namely an at-risk population for serious illness and complications. This is due to the state’s aging population and large percentage of residents with chronic health conditions. A Kaiser Family Foundation analysis put West Virginia at the highest percentage in the nation of adults at risk of serious illness from COVID 19- over 50 percent.
Despite the risks that our population faces, West Virginia has very few resources to provide diagnostic testing for the virus. According to the state’s public health commissioner, we currently have the resources to perform about 500 tests statewide. Our state has not been a priority to receive testing kits because our lack of current positive diagnoses, which puts us in a resource catch 22. We won’t be prioritized until we have more positive cases, but we can’t diagnose positive cases without access to tests. As of March 17, West Virginia has tested 136 residents, or 0.0076% of our state’s population.
While not solving our testing capacity crisis, the Families First Coronavirus Response Act (FFCRA) has several health provisions that will provide critical support to states. The US House passed the bill and the Senate is expected to vote on it imminently. Experts and lawmakers on both sides of the aisle warn that this is only the tip of the iceberg in terms of policies that will be needed to adequately address the crisis, but this is an important start.
The FFCRA increases federal Medicaid funding to the states by boosting the Federal Medical Assistance Percentage (FMAP) by 6.2 percent from January 1, 2020 throughout the end of the public health crisis. The FMAP is a calculation that determines what the state’s share of Medicaid costs are vs. the federal government’s share. West Virginia has one of the highest FMAP rates in the country, due to our high poverty and low median income. In FY 2020, our FMAP is 74.94%, meaning that the federal government pays nearly three-fourths of every dollar spent on Medicaid services. With the temporary boost from this legislation, the federal share will rise to 81.14%. Preliminary estimates are that this would send an additional $200 million in federal Medicaid funds to West Virginia.
The FMAP boost is one of the quickest ways the federal government can shift money to the states, both to help cover the potential cost of increased numbers of people on the Medicaid rolls seeking health treatment in a public health and economic crisis and to free up state resources to address other budgetary needs.
On Tuesday, Senators Capito and Manchin also announced a $5.5 million grant from the Centers for Disease Control and Prevention (CDC) to be used to provide safety and medical resources to our state’s health care professionals.
At the state level, the response to this point has largely been to enforce social distancing through an order from the Governor to close public schools and, more recently, to close bars and restaurants to in-person dining.
Over the weekend, the WVCBP along with several other organizations published recommendations that the Governor and state’s agencies could do administratively to protect public health and financial security of residents in the Charleston Gazette Mail. These recommendations included waiving time limits on SNAP (food stamps), barring evictions and utility shut offs, utilizing flexibility in Medicaid to keep residents from losing coverage, and waiving waiting periods for unemployment insurance benefits.
Additional legislative responses could be considered if a special session of the legislature is called, though the public health implications of gathering legislators and Capitol staff is a concern. Potential legislative responses could include:
Allocation of state funds to address public health crisis- The legislature could allocate money from the state’s rainy day fund or the current Medicaid surplus to the governor’s contingency fund to address the necessary public health response. The state’s rainy day fund has a current balance of just over $858 million.
Emergency paid sick days– Although the federal FFCRA does include an emergency sick leave provision, it leaves many West Virginians out with a provision that excludes those who work for businesses with over 500 employees, which is just over 50 percent over West Virginia workers. The federal legislation also allows employers with less than 50 employees to receive exemptions. State legislation could protect workers who are currently excluded from the federal proposal by including all workers regardless of employer size.
Unemployment Insurance Improvements- More than half of states in the US utilize a program called “work sharing”, which allows employers to reduce workers’ hours rather than a layoff. In states with work sharing programs, workers with reduced hours can supplement their wages with pro-rated unemployment benefits. This allows an employer, for example, to reduce all employees’ hours by 25 percent rather than laying off 25 percent of staff.
