Commentary: Make no mistake: Capito Care makes life-changing cuts to Medicaid

By Ellen Allen

Originally published on September 25, 2025 by West Virginia Watch. 

West Virginians for Affordable Health Care has been touring the state — from Ohio County to Mercer County — in a nonpartisan collaboration to educate West Virginians on how H.R. 1 will impact our communities. And this work is just beginning. We’ve launched a 55 county tour to shine a light on the largest cuts to health care in our nation’s history.

I’ve had the pleasure of being an occasional guest on MetroNews Midday with Dave Allen and Amanda Barren to talk about health care and emerging policy that will affect West Virginian’s ability to afford and access health care. I always enjoy the experience and look forward to educating West Virginians about the realities of how policy choices made by our representatives — on our behalf — can affect their families and their daily lives.

On my most recent appearance, I was asked how is it that you say Medicaid cuts will devastate West Virginia’s health care infrastructure, yet Sen. Shelley Moore Capito was just in our studios and said Medicaid was not cut at all?

My response: I don’t understand how the senator can claim that. Surely, she has read the bill.  

Medicaid is West Virginia’s single largest source of federal funding. It sustains thousands of jobs, keeps rural hospitals and clinics open, and injects billions into our local economy each year. In fact, Medicaid spending in West Virginia totals $5.5 billion annually, with 82% of that supported by federal dollars.

Read that again: 82% of our state’s Medicaid funding — the largest health insurance program in our state — comes from the federal government.

Over 500,000 West Virginians count on this coverage — from our youngest to our oldest, and everyone in between — including working families, people with disabilities, and those who need expensive or long-term care they couldn’t afford on their own.

According to Families USA, , H.R. 1 is devastating for West Virginia, stripping more than $666 million each year in federal Medicaid funding. The damage will only grow as the provider tax is reduced and gradually phased out in Medicaid expansion states like ours, all while a moratorium blocks any new or increased provider taxes.

This matters. The provider tax — a levy placed on hospitals, nursing homes and managed care organizations — is a critical source of state revenue for Medicaid. It serves as the primary funding mechanism for the state’s share of Medicaid costs, allowing West Virginia to draw down billions in additional federal dollars. Those funds support both mandatory and optional Medicaid services. Limiting or phasing out this tax, is in effect, a direct threat to the foundation of Medicaid’s funding in our state.

Mandatory essential services

  • Early and periodic screening, diagnostic and treatment: Comprehensive health services for individuals under 21
  • Federally qualified health center services
  • Home health services for those who are eligible for nursing facility care
  • Inpatient and outpatient hospital services
  • Laboratory and X-ray services
  • Nurse-midwife services
  • Nursing facility services for adults over 21
  • Physician services
  • Rural Health Clinic (RHC) services
  • Transportation to and from medical care

Optional services

  • Ambulance transportation
  • Dental services: West Virginia covers dental for children, but coverage for adults is generally limited to emergency services
  • Eyeglasses and optometry services
  • Hospice care
  • Intermediate care facilities for individuals with intellectual disabilities
  • Mental and behavioral health services
  • Personal care services
  • Prescription drugs
  • Psychological services
  • Rehabilitation service.
  • Speech, hearing, and language services
  • Waiver services including:
    • Aged and disabled waiver
    • Children with serious emotional disorder waiver
    • Intellectual and/or developmental disabilities waiver
    • Traumatic brain injury waiver

What do our lawmakers cut first — dental care, mental and behavioral health, nursing home care or the waiver that supports West Virginians with disabilities? These are the devastating choices that Capito Care has forced onto our state lawmakers and onto our communities.

It doesn’t have to be this way. H.R. 1 was a choice — a policy decision led by our senior senator, Shelley Moore Capito, and backed by Sen. Jim Justice, Rep. Carol Miller and Rep. Riley Moore. Capito Care weakens Medicaid across the board, straining our health care infrastructure, reducing access, and raising costs for everyone. The truth is: Medicaid didn’t need saving, but after these reckless cuts it does. These cuts must never see implementation.