Last week, West Virginia’s Bureau for Children and Families released updated state Medicaid enrollment figures. The data revealed that 6,500 additional West Virginians registered for the program in September. Since the start of the COVID-19 pandemic in February – and the subsequent loss of employment and wages – 53,500 additional individuals have gained coverage. This figure represents a 10 percent increase in West Virginia’s Medicaid program between February and September.
The state experienced its most significant enrollment increases in March and April, averaging 10,700 newly registered West Virginians in Medicaid per month. Since then, the number of new enrollees has stabilized, averaging about 6,400 new individuals per month. In September, West Virginia reached 542,000 total individuals enrolled in Medicaid.
When the U.S. Department of Health and Human Services (HHS) declared a state of emergency in March, it allowed West Virginia to incorporate flexibilities that have since benefitted individuals’ access to Medicaid. One significant change has been extending maintenance of eligibility (MOE) requirements, which mandates that states continue to provide coverage for current Medicaid enrollees. This provision has contributed to the overall increase in the number of people on Medicaid as the state’s Department of Health and Human Resources cannot drop individuals’ coverage during a state of emergency.
While it remains unclear how many new recipients enrolled in Medicaid under the expansion, increased unemployment levels alongside increased Medicaid registration indicate a potential correlation. Unemployment spiked to 16 percent in April and has steadily declined to reach 8.6 percent in September. This figure remains higher than the five percent unemployment rate at the start of the year. Despite decreasing levels of unemployment, the job recovery of the state has slowed significantly. From August to September, the rate of unemployment fell by just 0.3 percent.
Although there has been some progress regarding employment levels, the state Medicaid program continues to grow. Over the past few months, West Virginia has experienced decreasing unemployment levels alongside increasing Medicaid enrollment numbers. While unemployment has fallen by 50 percent since its peak in April, 43,000 new people registered for Medicaid over the same period.
Several factors could explain why a similar decrease in Medicaid enrollment has not accompanied the recovery in unemployment levels. First, as highlighted, MOE has prevented the state from dropping individuals from the state Medicaid program. Another factor contributing to this discrepancy is that West Virginia’s real unemployment rate, which includes those who have left the workforce, reveals that job recovery has been worse than officially reported. Those statistics describe a 12.3 percent unemployment rate in September—four percentage points higher than the month’s official unemployment rate.
Finally, changes to Medicaid enrollment numbers simply lagging behind changes in unemployment levels can explain the negative relationship between Medicaid and unemployment. If this is the case, given the slowing recovery and elevated real unemployment rate, Medicaid enrollment numbers may continue to rise steadily as observed over the past few months.
The increasing numbers of Medicaid recipients in West Virginia highlight the critical need for the program, especially during a global crisis. The Medicaid figures for September underscore a trend already made apparent over the past few months: as the state continues to recover, it must maintain flexibilities, such as MOE, beyond the pandemic. Additionally, as federal lawmakers deliberate the need for additional relief to individuals and state and local governments, they should consider continuing the increased federal Medicaid match to help states cover increased enrollment costs. Such actions will ensure that Medicaid is accessible to everyone eligible and would contribute to keeping West Virginians healthy.
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