Renate Pore: Getting down to bipartisan health care solutions, we can help

Charleston Gazette   September 7, 2017

More than 25 organizations representing thousands of West Virginians have written to Sen. Shelley Moore Capito, R-W.Va., urging her to work in a bipartisan manner to preserve health care for West Virginians.

As a group, we worked hard this year to defeat Republican bills that would have taken health care away from more than 20 million Americans and more than 200,000 West Virginians. We were relieved when these bills failed to pass. We were grateful that Sen. Joe Manchin, D-W.Va., never wavered in his opposition to these harmful bills and encouraged by Sen. Capito’s public statements such as:

“I did not come to Washington to hurt people. For months, I have expressed reservations about the direction of the bill to repeal and replace Obamacare. My position on this issue is driven by its impact on West Virginians. With that in mind, I cannot vote to repeal Obamacare without a replacement plan that addresses my concerns and the needs of West Virginians.”

Looking ahead, we see opportunities for bipartisan approaches to achieving our shared goals of quality, affordable coverage for all West Virginians.

Medicaid is a life-line for more than 600,000 West Virginians

— including children, lower income working adults, seniors, people with disabilities, and people who need long-term care and services. In calendar year 2016, 76 percent of the children in our state relied on Medicaid to help pay for needed health services. More than half of all nursing home and home-based and community-based long-term care is paid for by Medicaid.

We are concerned that Medicaid continues to be threatened by proposed significant cuts in the president’s budget and the House of Representatives budget.

The 2018 state budget fills the Medicaid budget with $60 million in one-time state dollars. This is unsustainable. We do not expect that, at any time in the future, the state will have the revenue to absorb federal Medicaid cuts. For better or worse, we are dependent on the federal government to protect West Virginians’ health. As a state which has sacrificed its people to mine the nation’s coal and has sent a higher proportion of its young men and women to serve in the nation’s wars than many other states, we are not apologetic for needing federal support at this time in our state’s history

 As experts on Medicaid, our experience has taught us that there are no magic bullets or efficiencies to be achieved in the Medicaid program to achieve cuts in spending of the magnitude being proposed in Washington. We can be proud of the slow growth rate of our state’s Medicaid program compared to private health insurance (including employer-sponsored coverage). It is an efficient program and our Medicaid managed care organization contracts are models for other states.

To be clear, cuts in federal funding will translate into cuts to eligibility and to health care services, and cuts to provider reimbursement rates. We are deeply concerned about what these cuts will mean for Medicaid benefciaries, our rural health infrastructure and jobs.

We acknowledge Sen. Capito’s leadership efforts to secure new dollars to fight the opioid epidemic in West Virginia. But compared to Medicaid spending for opioid treatment, these dollars are insufficient. Moreover, as the senator has emphasized, people struggling with opioid addiction need comprehensive coverage that lets them access not only substance-use treatment, but also the other mental and physical health services they need.

Looking to the future, we hope Sen. Capito will agree that it is time to have a bipartisan health care debate that addresses the

immediate concerns to stabilize the health insurance markets and discuss the underlying issues of high health care costs in the United States. For the longterm, we also need a rational policy debate that takes into account the real interests of all Americans for affordable, quality health care rather than using health care as a political football.

We ask Sen. Capito to commit to the following as she returns to session and begin key conversations on important legislation that will affect the futures of many West Virginians. Sen. Manchin has already agreed to do so.

We want the Congress to focus on a bipartisan effort to strengthen our marketplace, improve affordability and expand, rather than reduce, coverage. We want Sens. Manchin and Capito to work to ensure that the Senate budget resolution does not require the same deep Medicaid cuts that were widely opposed during the health care fight and would affect so many West Virginians.

The West Virginians Together for Medicaid Coalition stands ready to help — with facts and nonpartisan analysis — to understand the impact on West Virginians of any Medicaid, CHIP, or Affordable Care Act marketplace proposals.

Renate Pore is chairwoman of West Virginians Together for Medicaid Coalition.