W.Va. lawmaker questions cost estimates of federal health care bills, seek new calculations

W.Va. lawmaker questions health care cost figures

CHARLESTON, W.Va. — A top lawmaker has asked West Virginia to re-examine its estimate that federal health care legislation could cost the state hundreds of millions of dollars.

Delegate Don Perdue, chairman of the House Health and Human Resources committee, said Monday that the state agency that produced the estimates has agreed to look at them again in light of questions over how the projections were reached.

Earlier this month, Gov. Joe Manchin said the Department of Health and Human Resources estimated that the expansion of Medicaid envisioned by two different federal bills would carry a hefty price tag for West Virginia.

The bill in the House of Representatives, which would offer Medicaid coverage to people making up to 150 percent of the federal poverty level, would cost West Virginia $725 million by 2019, according to the estimate.

DHHR estimated that the Senate plan, which would make Medicaid — the federal health care program for the poor — available to people earning up to 133 percent of the federal poverty level, the state’s costs would go up by nearly $148 million.

The current federal poverty level is $10,830 for individuals and $22,050 for a family of four.

The estimates have been cited by opponents of the health care legislation who say the bills will be a crushing financial burden for state governments.

Manchin, though, doesn’t think the numbers amount to an indictment of federal health care legislation, spokesman Matt Turner said.

“While DHHR has produced those estimates, the governor understands they are based on presumptions and are just that: estimates,” Turner said. “He considers them a tool for us to use, but is not basing his support of health care reform on that.”

Based on numbers his staff has produced, though, Perdue said those estimates may as much as double what the state’s costs would actually be.

The DHHR estimate is based on the assumption that 260,000 uninsured residents would be newly eligible for, and enrolled in, Medicaid coverage. That’s where the problem lies, according to Perdue.

“That figure is vastly overstated,” Perdue said. “They assume everyone who is uninsured will go to Medicaid, and that’s not accurate.”

Although there is no final federal legislation, Perdue said a completed bill will almost definitely offer a chance for individuals and small businesses to buy coverage in new health insurance markets called exchanges.

That would attract West Virginians who are currently uninsured, Perdue said, and many of the children eligible for Medicaid under the expansion would remain in the State Children’s Health Insurance Program, often abbreviated as CHIP, if that program stays in place.

The state’s estimates have also raised objections from health care overhaul advocates, who say the numbers don’t make sense.

According to a U.S. Census estimate released last September, there are roughly 271,000 West Virginians without health insurance. There’s no way 260,000 of them would be eligible for Medicaid under either the House or the Senate plan, said Perry Bryant, executive director of West Virginians for Affordable Health Care.

“That assumption really jumps out as being puzzling,” he said.

Based on Census income estimates, Bryant estimates that at most, about 104,000 West Virginians would be eligible for Medicaid coverage under the House plan, and fewer under the Senate plan.

Bryant’s group has called on DHHR Secretary Patsy Hardy to retract the estimates.

The agency is taking a second look at its estimates, spokesman John Law, but he added any figures will be premature until there’s a final bill in Washington.

“While all involved are interested in numbers, it’s important we keep our focus on the passage of the national legislation and reforming the system,” he said.