At the WVCBP, we are tracking policy changes and flexibilities that impact the ability of West Virginians to utilize the safety net during the COVID-19 crisis. This post highlights changes to Medicaid, SNAP (food stamps) and TANF, as well as additional flexibilities in state and federal law that West Virginia should utilize to improve access to these important safety net resources.
You can apply for all three programs (Medicaid, SNAP, and TANF) as well as additional help like home energy assistance and child care subsidies at wvpath.org.
We will update this post as new policies are implemented.
FFCRA Under the federal Families First Coronavirus Response Act (FFCRA), several Medicaid provisions were put in place to ensure ongoing coverage for West Virginians. The legislation boosted the portion of Medicaid spending that the federal government kicks in. This is done by increasing the Federal Medical Assistance Percentage (FMAP) by 6.2 percent. If the FMAP “boost” remains in place through the end of 2020, it will send approximately $200 million in additional federal funding to West Virginia’s Medicaid program.
Each state is required to comply with “maintenance of effort” (MOE) requirements in order to pull down the additional federal Medicaid dollars, meaning they have to continue providing coverage to those who need it. That means that for as long as the public health emergency declaration remains in effect, states are barred from ending coverage for any Medicaid beneficiary with two exceptions: individuals who ask to be disenrolled or those who move out of the state.
In order to fully comply with the MOE provision and to shift resources to what will surely be a surge of new Medicaid applicants, West Virginia’s Department of Health and Human Resources (DHHR) should consider ceasing redeterminations and halting the use of periodic income checks throughout the public health emergency.
For new Medicaid applicants, West Virginia has flexibilities available through the emergency declaration that can help qualify applicants more quickly and allow the agency to obtain needed verification post-enrollment. This involves utilizing federal electronic income data sources when possible, expanding the use of presumptive Medicaid eligibility, and approving/enrolling applicants right away.
The FFCRA allows Medicaid to cover COVID-19 testing for uninsured individual. The legislation also allows states to relax quantity limits and extend refills, expand coverage to all children and pregnant women, and expand eligibility.
WV’s 1135 Waiver At the state level, West Virginia applied and was approved for an 1135 emergency waiver which largely dealt with flexibility on the provider side, waiving prior authorization requirements and allowing providers that are not enrolled in the West Virginia Medicaid program to bill Medicaid during the public health emergency in order to increase the state’s health care capacity.
West Virginia’s DHHR is expected to apply for additional waivers in order to increase services available and flexibilities within the Medicaid program.
CARES Act The third phase of federal legislation in the coronavirus response also contains an important Medicaid-related provision. The Coronavirus Aid, Relief, and Economic Security Act (CARES Act) provides three key expansions to state’s unemployment insurance programs. Pandemic Unemployment Compensation (PUC) provides for unemployment claimants to receive their usual state benefit plus an additional $600 per week in unemployment compensation.
While the state share of unemployment compensation counts as income for Medicaid and CHIP, the $600/week PUC payment does not count as income for the purposes of Medicaid and CHIP eligibility. It does count as income for individual health plans on the healthcare.gov marketplace. This makes it incredibly important that those who lose their health insurance with a job loss go to the state’s Medicaid website, wvpath.org, and apply there prior to looking at the healthcare.gov marketplace. The Economic Policy Institute estimates that over 7,000 West Virginians lost their health coverage over the last two weeks and many will be eligible for Medicaid.
West Virginia has taken advantage of several flexibilities made available through recent federal legislation in order to keep as many current SNAP beneficiaries receiving benefits without interruption during the COVID-19 pandemic. Additionally, for the months of April and May, WV has secured a waiver allowing current SNAP households automatic access to the maximum allowable benefit for the months of April and May
Those who are applying for SNAP due to loss of work or drastic reductions in their hours due to COVID-19 can take advantage of online applications and telephonic interviews that once were mandated to be in person. The aforementioned actions by federal and state entities are a positive first step but more must be done to support West Virginia workers and families during this unprecedented public health and family economic security crisis.
While 15.5 billion dollars in federal aid was allocated for SNAP in recently passed federal legislation, lawmakers missed an opportunity to increase the maximum monthly benefit by 15% and make the minimum monthly benefit no less that 30 dollars. Such policy actions should be prioritized if/when Congress passes its next stimulus. SNAP is a proven economic multiplier during recessions. Every dollar of SNAP spent leads to between $1.50 and $1.80 in economic activity.
West Virginia can also take important steps to improve the benefit delivery process.
Improve Front End Touch points
Surge Backend Process Capacity
Abridge the Adjudication Process
Maximize Ease of Use of Benefits
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