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W.Va. to benefit more from ACA than most other states

CHARLESTON, W.Va. -- West Virginians will see more benefits from the Affordable Care Act, commonly known as Obamacare, than residents of almost any other state, according to a new study from the Robert Wood Johnson Foundation.

In West Virginia 81 percent of currently uninsured residents will receive some sort of financial help in getting health insurance, either through Medicaid or through subsidies in the health insurance marketplace, the study found. That number is tied with Michigan and Kentucky for the highest in the nation.

"This is not small news," wrote Brandon Merritt, a health policy analyst with the West Virginia Center on Budget and Policy. "Currently, there are an estimated 270,000 West Virginians without health insurance. Based on this report, around 219,000 of them will qualify for assistance, which is a pretty big deal since cost is overwhelmingly the number one reason why the uninsured don't have health coverage."

States, like West Virginia, that chose to expand Medicaid will benefit most from the ACA, the study found.

An estimated 159,000 West Virginians will be eligible for insurance through the Medicaid expansion. Medicaid was expanded to include everyone who makes up to 133 percent of the federal poverty level, about $31,000 for a family of four.

An additional 60,000 West Virginians will be eligible for tax subsidies to help them buy insurance on the newly created health insurance marketplace. Subsidies are available for people lacking insurance who earn up to 400 percent of the federal poverty level, about $94,000 for a family of four.

People who live in nine Southern states, from Virginia southwest to Texas, will have the poorest opportunities in the country to improve their health insurance coverage under the ACA. That's because those states opted not to expand Medicaid.

The Johnson Foundation study points out, "The share of the uninsured that is eligible for assistance programs is heavily dependent on a state's decision whether to expand Medicaid eligibility."

In the 25 states that are not currently expanding Medicaid, all of which have Republican governors, somewhere between 34 and 53 percent of uninsured residents will get assistance.

In the 25 states that are currently expanding Medicaid the range of uninsured residents who will get assistance is between 59 and 81 percent, the study found.

Texas is on the opposite bottom of the spectrum, in large part because Gov. Rick Perry refused to expand Medicaid coverage in his state.

In Texas, only 34 percent of its currently uninsured residents will receive any assistance under ACA provisions, the study found. That assistance will be available only in the form of tax credits for people who earn enough to qualify for those credits.

This creates an odd situation in which the poorest residents, those who would be eligible for Medicaid under the expansion, will receive no assistance, while those with slightly greater incomes will receive subsidies to help purchase insurance.

"Texas leads the country in the number and percentage of uninsured state residents, where more than 25 percent of Texans don't have health insurance, including an embarrassingly high 17 percent of children," Merritt wrote.

Perry's decision not to expand Medicaid will make it impossible for the poorest 1.7 million Texans, whose incomes are less than 138 percent of the "federal poverty level," to qualify for medical assistance, Merritt wrote.

Federal and state governments jointly fund Medicaid programs.

The federal government will cover 100 percent of the funding to expand Medicaid for the first three years. After three years, that number will scale down to no less than 90 percent.

Federal funds are a specified percentage of Medicaid benefits in each state, based on criteria such as per capita income.

The average federal funding rate for Medicaid is currently 57 percent, ranging from 50 percent in wealthier states to 75 percent in states with lower per capita incomes.

During fiscal year 2012, West Virginia received 72.6 percent of its Medicaid expenditures from federal funds, while Texas received 58.2 percent, according to the Department of Health and Human Services.

"Fortunately," Merritt concludes, "we have a governor and state legislature who were able to look beyond the Obama in Obamacare long enough to see that expanding Medicaid was both the right thing to do for our most vulnerable West Virginians and the economically smart thing to do for the state and its labor force."

To read the full Johnson Foundation study go here.

Reach Paul J. Nyden at pjnyden@wvgazette.com or 304-348-5164.


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