No to Government Shutdown: West Virginia Can and Should Keep Our Kids Covered

The federal government is staring down a shutdown.  The current spending laws expire at 11:59 p.m. Sept. 30. Without a deal by Saturday night, funding will lapse and many government functions, including some health care programs, will temporarily stop.

For the first time since 2019, congressional gridlock is poised to at least temporarily shut down big parts of the federal government. It can be easy to say, well, that doesn’t really affect me.

But what about the many health programs that so many West Virginians depend upon?

In the short term, mandatory spending programs would be mostly, but not completely, unaffected by a government shutdown. Benefits would continue under programs like Medicare, Medicaid and the Affordable Care Act, and doctors and hospitals could continue to submit bills and get paid.

But federal staffers not considered “essential” would be furloughed: That means initial Medicare enrollment could be temporarily stopped. We are not a particularly young state — this will be felt by West Virginians just celebrating their 65th birthday.

Another particular area of vulnerability for West Virginia is that a shutdown would also threaten the United States Department of Health and Human Services’ oversight of the Medicaid “unwinding” process, as states reevaluate the eligibility of those enrolled in the program for low-income people. We know our state is working very hard and will continue to perform reviews to enroll as many West Virginians as quickly as possible.

But because of federal furloughs, technical assistance to help states address unwinding problems and adopt mitigation strategies could cease. Efforts to determine if there are further renewal processes that are out of compliance with federal requirements could be limited or ended.

For the months of April through August, the state of West Virginia removed more than 100,000 people from Medicaid or CHIP. Unfortunately, many of these are procedural errors that the state is working hard to fix. Technical assistance from the federal government is of vital importance to this process.

Uninsured kids and families needlessly losing health care inflates uncompensated care costs of hospitals and health centers : About 13,000 West Virginians are losing their health care coverage every month since unwind started last spring.

Federal researchers projected that 3 out of 4 children losing Medicaid would remain eligible — a very troubling statistic as procedural terminations or “red tape” losses pile up — rather than eligibility determinations that actually ascertain whether a child is eligible for Medicaid or not.

West Virginia is expected to restore health coverage to approximately 5,500 children who were wrongly removed from the Medicaid rolls because of an issue with the eligibility system. A government shutdown could create barriers to children receiving the health care they need.

Medicaid has always played a vital role as an insurer for low-income families in the Mountain State — particularly kids. Medicaid and CHIP are integral to our health care system, and it insures nearly half of West Virginia’s kids. According to the Kaiser Family Foundation, 47.1 percent of West Virginia’s kids qualify for Medicaid and CHIP. The national average is 39 percent. In light of the unwinding with the consequences of procedural errors, that is quite a stunning number of people impacted — our friends, neighbors and family. These are real hard consequences.

If the shutdown is prolonged, more programs could be affected. For example, the U.S. department of health’s shutdown contingency document says that “CMS will have sufficient funding for Medicaid to fund the first quarter” of fiscal year 2024. The government has never been shut down long enough to know what would happen after that.

WIC program benefits (supplemental nutrition for women, infants, and children) offered by local health departments will cease in the event of a shutdown.

Head Start programs would not be able to draw on funds to pay staff and operating expenses, and according to the West Virginia Head Start Association, over 7,000 children are enrolled in Head Start.

About half of staffers at the Center for Medicaid Services would be furloughed in a shutdown. That could complicate a lot of other activities, starting with historic drug price negotiations set to begin Oct. 1.

This matters. It all matters. This is where what happens in Washington affects us at home. It’s not pretty. We should all be very worried and pay attention, and demand more — especially for children. Everyone should be talking about this — we’re all stakeholders in this effort.