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Reducing federal dollars for Medicaid expansion could cut millions from the rolls

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westvirginiawatch.com – Shalina Chatlani – 2025-02-17 05:00:00

by Shalina Chatlani, West Virginia Watch
February 17, 2025

Depending on how states respond, a Republican proposal circulating on Capitol Hill that would slash the 90% federal contribution to states’ expanded Medicaid programs would end coverage for as many as 20 million people — or cost states $626 billion over the next decade to keep them on the rolls, according to a new analysis.

The Trump administration and Republicans in Congress are eyeing reductions in federal spending, largely to pay for extending tax cuts enacted during Trump’s first term in office. Medicaid, the joint federal-state health care program for low-income people and people with disabilities, covers 1 in 5 people living in the U.S. and accounts for nearly $1 out of every $5 spent on health care.

According to a document shared with Politico, one idea under consideration by the U.S. House Ways and Means Committee is to shrink the current 90% federal funding match for states that have expanded Medicaid under the Affordable Care Act. Under the proposal, Congress would reduce the federal match for the expansion population to the percentages states get for the traditional Medicaid population — 50% for the wealthiest states and 77% for the poorest ones.

Under the ACA, states have the option to expand their Medicaid programs to cover adults with low incomes up to 138% of the federal poverty level ($21,597 for an individual in 2025), instead of just limiting coverage to children, parents of young children and people with disabilities. The built-in incentive to expand was that the federal government’s promise to pay 90% of the cost of expansion from 2020 and beyond, meaning states just had to pay the remaining 10%.

Forty states plus the District of Columbia have opted to expand. The holdouts are Alabama, Florida, Georgia, Kansas, Mississippi, South Carolina, Tennessee, Texas, Wisconsin and Wyoming.

Research released this week by the health policy research group KFF finds that two major scenarios could happen — both of which might diminish patients’ access to health care coverage.

The first possibility is that expansion states would use their own money to make up for lost federal dollars. That would cost them about $626 billion over 10 years, an overall spending increase of 17%. To shoulder the heavier burden, states likely would have to scale back Medicaid coverage for some groups, eliminate optional benefits or reduce provider payment rates. Alternatively, they could raise taxes or make cuts in other large budget items, such as education.

A second potential outcome is that states that have adopted Medicaid expansion would reverse it. Nine states (Arizona, Arkansas, Illinois, Indiana, Montana, New Hampshire, North Carolina, Utah and Virginia) already have “trigger” laws in place that would automatically rescind expansion if the federal match rate dips below 90%. Other states are considering similar legislation.

If all the states (plus D.C.) that have expanded Medicaid under the ACA reverse it, 20 million people, or nearly a quarter of all Medicaid enrollees, would lose coverage, according to KFF. Among expansion states, overall Medicaid spending would decline by 6%.

States that have not expanded Medicaid would not be affected under either scenario.

Stateline is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. Stateline maintains editorial independence. Contact Editor Scott S. Greenberger for questions: info@stateline.org.

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West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.

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News from the South - West Virginia News Feed

Two fatalities confirmed in weekend flooding in WV; Morrisey gives update on recovery efforts

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westvirginiawatch.com – Caity Coyne – 2025-02-18 17:48:00

Two fatalities confirmed in weekend flooding in WV; Morrisey gives update on recovery efforts

by Caity Coyne, West Virginia Watch
February 18, 2025

At least two people have now died due to flooding in West Virginia’s southern coalfields, where already struggling communities were washed out in a torrent of rain that hit over the weekend.

The two victims, Debbie and Donald Griffin, were from Welch. Gov. Patrick Morrisey said at least one other person is still missing in McDowell County, where search and rescue teams were active Tuesday.

Morrisey said he spent Monday surveying damage across the coalfields, with specific stops in Mingo and McDowell counties. 

“I first met some people who seemed to have lost everything …,” Morrisey said. “I want to send a message that the state is looking to do everything possible through its efforts and its resources to be helpful.”

As a state, the governor said agencies have taken on a “unified response” in both cleaning up debris left by the flood waters and coordinating response efforts for those who need assistance. 

Five liaison officer teams from the West Virginia National Guard were working throughout the region while local and state emergency responders were combining efforts. Members of the West Virginia State Police, the state fire marshal’s office and those with corrections were operating drones to survey damage from above and help concentrate recovery efforts in places that needed it most. Workers from the state Department of Transportation, the Division of Natural Resources and the Department of Environmental Protection, among others, were also on the ground.

Morrisey said a bright spot in the ongoing devastation across the coalfields was how West Virginians — and those from outside the state — have stepped up to help their community through donations and cleanup efforts. He said bottled water had been donated from multiple residents who were spared from the floods. Other donations came in from as far away as Texas. 

“I saw so much volunteer efforts and food and water and people that cared so much. That’s the West Virginia way,” Morrisey said. “… We thank everyone who is putting themselves in harm’s [way] to save the lives of their neighbors. There’s no substitute for that — people acting selflessly to help their fellow West Virginians.”

Boil water advisories so far have been issued for residents served by public service districts in Williamson, McDowell, Kermit, Mingo and Crum. Those who rely on those systems for water should abstain from drinking anything coming out of their taps until further notice.

Water service in general was still out completely for portions of both McDowell and Mingo counties, Morrisey said. Utility operators, he continued, were working to flush lines and restore service as soon as possible on Tuesday.

In addition to the water outages, power remained out for more than 8,000 West Virginians on Tuesday, Morrisey said. Utility workers and others had restored power to nearly 56,000 residents on Tuesday. In some areas, responders were needing to wait until flood waters receded and debris was cleared out before repairing power lines.

Flood waters can be breeding grounds for disease due to contaminants that could enter the body through open wounds, among other ways. There can also be dangers — loose metal, sharp objects and more — hidden in flood waters, which can be hazardous for people caught in them. Morrisey said 250 tetanus shots were sent this week to Williamson Memorial Hospital and to Wyoming County for anyone who may have been exposed in the overflowing waters.

At least four school districts — in Mingo, McDowell, Raleigh and Wyoming counties — had closures on Tuesday for either power outages, road closures or damage from floods. In several of those counties, schools were being used as shelters or distribution centers for people displaced by the floods and in need of supplies. Social media postings from Mingo and McDowell on Sunday said both districts would be closed “until further notice,” however no announcements regarding any closures were posted on the state Department of Education’s website as of 4 p.m.

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Morrisey’s State of the State didn’t touch on some of West Virginia’s biggest problems

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westvirginiawatch.com – Leann Ray – 2025-02-18 04:55:00

Morrisey’s State of the State didn’t touch on some of West Virginia’s biggest problems

by Leann Ray, West Virginia Watch
February 18, 2025

West Virginia, I love you so much, but why do you continue to vote for people who won’t do anything to help you?

You can’t keep voting for the people who say “Trump” and “Jesus” the most and claim they know better than experts, then expect West Virginia to take a rocket ship ride to the top.

There are thousands of children in foster care, and we have a shortage of Child Protective Service workers. In 2023, there were 5,286 child abuse and neglect cases filed in circuit courts in West Virginia alone. Gov. Patrick Morrisey didn’t mention anything about that in his State of the State address.

However, he did spend a good portion of his speech talking again about how he’s going to “eradicate the woke virus from infecting our schools.”

Morrisey also briefly touched on the state’s opioid epidemic, but he placed most of the blame on the “open southern border and lax immigration enforcement.”

He was correct in saying that more than 80% of overdose deaths in West Virginia were from fentanyl, however, most of it is not coming from immigrants.

More than 85% of people charged with fentanyl trafficking annually are U.S. citizens, according to the U.S. Sentencing Commission. Nearly 82% of all convicted drug traffickers in 2023 were U.S. residents. More than 90% of the fentanyl that is seized at the Mexican border comes through legal points of entry, according to U.S. Customs and Border Patrol.

Experts say evidence-based harm reduction strategies can minimize overdoses and diseases contracted through sharing needles.

And yet, lawmakers have made it almost impossible for anyone to start a syringe services program in West Virginia, and last year banned those programs from distributing safe smoking supplies. In the first few days of session, there have already been more bills introduced to make syringe exchange programs and all opioid treatment programs unlawful.

Morrisey didn’t mention anything about school discipline — another huge problem — but he did mention President Donald Trump eight times during his speech.

And on Friday, 13 lawmakers introduced House Concurrent Resolution 33 to rename Spruce Knob, the tallest point in the state, as “Trump Mountain.”

It’s very much giving, “The leader is good, the leader is great, we surrender our will, as of this date.” 

Thousands of West Virginians are without clean water, but Morrisey didn’t mention anything about it or utility infrastructure. But he did spend a chunk of his speech focusing on erasing transgender people somehow without using the word transgender.

He bragged about joining Trump in the White House while he signed an executive order that banned transgender women from competing in women’s sports. In West Virginia, only one transegender girl has wanted to compete in women’s sports.

“As your governor, my duty is to protect and defend the citizens of West Virginia,” Morrisey said.

Unless you’re transgender. Or in active addiction. Or an immigrant. Or disabled. Or a minority  —  remember, Morrisey immediately banned diversity, equity and inclusion programs with an executive order on his second day in office? 

How are we supposed to convince businesses to relocate themselves and their employees here if we can’t provide them with the most basic human right: clean, running drinking water?

We’re only a few days into this session, there’s still time to focus on actual problems. Unfortunately, lawmakers don’t care what West Virginians have to say. They made that clear when they voted to end public hearings on day 1.

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Bills protecting foster families’ beliefs on LGBTQ, vaccines meant to recruit more WV foster homes

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westvirginiawatch.com – Amelia Ferrell Knisely – 2025-02-17 19:12:00

Bills protecting foster families’ beliefs on LGBTQ, vaccines meant to recruit more WV foster homes

by Amelia Ferrell Knisely, West Virginia Watch
February 17, 2025

As lawmakers try to help the state’s shortage of foster families, House members are considering a bill that would bar the state from dismissing potential foster families because of their “sincerely held” religious beliefs regarding sexual orientation or gender identity. 

Potential foster parents shouldn’t be excluded because of their religious beliefs, the bill sponsor said. Opponents of the measure fear it could put LGBTQ children at risk of being in unsupportive homes or potentially keep them from being placed in a home at all. 

Another measure would relax vaccination requirements for families wanting to foster, who are currently required to have their biological children in the home vaccinated in accordance with state policies. 

Members of the House Health Committee’s new Human Services Subcommittee, chaired by Del. Adam Burkhammer, R-Lewis, considered the measures on Monday during their first meeting this year. 

Burkhammer, a foster parent, said the bills addressed potential barriers to recruiting more foster families in the state. 

“The foster family is crucial to a well functioning child welfare system. And we need more of them that are willing to take children across the state,” he said. “There will be plenty more bills around child welfare as we move forward.”

There are more than 6,000 children in state care with a persistent shortage of Child Protective Service workers, foster homes and in-state care options. 

Del. Jonathan Pinson, R-Mason, is a foster parent and sponsor of House Bill 2033, which would ban the Department of Human Services from considering prospective foster parents’ beliefs on sexual orientation or gender identity as a condition of whether that individual is eligible to foster or adopt. 

“Such beliefs shall not create a per se presumption that any particular placement is contrary to the best interest of the child,” the bill said. 

“What we have many examples of throughout the nation are the human services employees asking questions to the foster parent, ‘So even in the instance of babies, would you affirm or would you be okay with some medical procedure or hormone therapy?’” Pinson told committee members. 

Research shows LGBTQ youth are overrepresented in the child welfare system for reasons that include LGBTQ youth face higher rates of parental physical abuse, and are more likely to run away from home or be kicked out.

“I worry about kids being placed in homes where we know that they might not be supportive,” said Jack Jarvis, communications director for Fairness West Virginia, a statewide LGBTQ advocacy organization. “I don’t think this bill does anything to protect the kids.” 

Del. Anitra Hamilton, D-Monongalia, feared that the bill prioritized the best interest for foster families’ safety more than children and could prevent LGBTQ or transgender youth in the foster care system from being placed in a safe home. 

“ … Because we put in a policy that further discriminates against our kids based on their sexual orientation or gender identity and them being able to be adopted by a loving family simply because of where they identify sexually,” she explained. 

Pinson said that he felt the bill makes sure that children are placed in the best environment where they can succeed.

He noted his legislation said that DoHS could use their discretion about where to place a child in hopes of finding a comfortable atmosphere. 

“We’ve gone to lengths to make sure that it’s not just protecting the foster parents, but also the foster children as well,” he said. 

The committee also considered HB 2376, sponsored by Burkhammer, that would exempt foster parents from having to show proof of vaccination for biological children and individuals living in the home, which is currently required. The measure would not give foster parents the ability to bypass vaccination requirements for foster children in their care.

Burkhammer said the measure was another way to increase the state’s number of potential of foster families 

Under a new House Committee process, the subcommittee is expected to consider the bills again and make any potential changes later this week.  

Members of the House Judiciary Committee have also begun reviewing foster-care related legislation that seeks to address issues in the judicial system, including a glaring lack of attorneys who represent children involved in abuse and neglect cases.  

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West Virginia Watch is part of States Newsroom, a nonprofit news network supported by grants and a coalition of donors as a 501c(3) public charity. West Virginia Watch maintains editorial independence. Contact Editor Leann Ray for questions: info@westvirginiawatch.com.

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