West Virginia working to find health care balance

As the national debate on universal — and hopefully affordable — health care continues to proceed in the halls of Congress in Washington, the state of West Virginia is pursuing its own efforts to provide adequate care without breaking the bank in two major areas.

First, the Public Employees Insurance Agency is engaged in a series of statewide public hearings for the thousands of public school employees and state government workers to receive feedback on the proposed changes to the PEIA health insurance program to make it more financially sound.

And Gov. Joe Manchin’s proposal to expand Medicaid coverage to many of the 271,000 West Virginians who lack health insurance now has been put on hold to await a final decision by Congress that could come later this year. This important component that is funded primarily by the federal government would still require a substantial sum of increasingly scarce state dollars as well.

Nearly 100 people showed up at the first PEIA public hearing in Charleston last week to voice their objections to the proposed changes in their health insurance plan that would be effective July 1, 2010. These changes include premium increases ranging from 4 percent to 8 percent along with boosts in members’ annual deductibles and an average increase in members’ out-of-pocket expenses for family coverage by ,500 a year.

The round of six public hearings will conclude in Huntington this week at 6 p.m. on Thursday at in the Harless Auditorium at the Marshall University Medical Center. The PEIA Finance Board will then meet on Dec. 3 to vote on whether or not to adopt any or all of these changes. Leaders of the organizations that represent the members covered by this health care program insist this is a continuing effort to shift more of the cost for this health care from the agency to the workers — a claim no one can dispute.

These critics raised the same objections a year ago when PEIA decided to eliminate retiree health insurance subsidies for all public school and state employees hired after June 30, 2010, despite widespread objections from the members of the plan at a similar series of public hearings.

And the latest idea from the unions who represent many of these public employees that the unions be allowed to take over PEIA and run this health insurance program for more than 200,000 public employees and their dependents so long as state government would continue to make “hefty annual contributions” to a union-managed trust fund is a terrible alternative.

The expansion of the state Medicaid program to allow more adults to be covered would raise the bar to persons with incomes up to 50 percent of the federal poverty level and also for the first time include adults without children. Right now, only those adults earning 35 percent of the federal poverty level who have children — the amount is ,050 for a family of four — qualify for state Medicaid assistance.

State lawmakers have objected to the governor’s proposed expansion of Medicaid coverage because the costs of the increase in the state’s share of this program were not available. That concern is understandable since even though Medicaid is largely paid for out of the federal treasury, the state does pick up a smaller part of that cost.

If the overall goal is to provide health care to at least 96 percent of the people in this nation, that means nearly 75,000 more West Virginians must be included in that coverage and an expanded Medicaid program may be the only way.There are growing indications next week’s special legislative session in Charleston expected to be called by the governor during the three days of monthly interim committee meetings might include some proposals for new funding sources for highway construction in West Virginia.

Both House Finance Chairman Harry K. White, D-Mingo, and Senate Finance Chairman Walt Helmick, D-Pocahontas, told people attending the 2009 West Virginia Transportation Conference in Beckley last week it’s time to look at user fees and even public-private options to augment the road user taxes on gasoline, vehicle purchases and license plates that now fund the 36,000-mile state highway system.

Helmick, known to be a fiscal conservative, even suggested the Legislature might want to explore the possibility of transferring some amount from the general tax revenues into the separate state road budget. Gov. Manchin, also present at the conference, did not mention this as an item for the anticipated special legislative session but did agree the state needs to look for some additional funding source.

One distinct possibility if additional road funding is considered next week would be to reconsider the Legislature’s decision earlier this year not to freeze the current gasoline tax at 32.5 cents per gallon. If the tax rate isn’t frozen before Jan. 1, 2010, the average wholesale price of gasoline between July 1, 2009. and Oct. 1, 2009, will require a drop of three to five cents a gallon and cost the road fund as much as million during the next budget year.The state’s financial future was painted as anything but rosy in the immediate future during an annual economic conference last week in Charleston. George Hammond from the WVU Bureau of Business and Economic Research said West Virginia’s per capita income of ,641 in 2008 was better than only one state in the union and 21.3 percent below the national average.

He said there were 22,600 fewer jobs in West Virginia during the second quarter of 2009 compared with the second quarter of 2008 which is why the state unemployment rate doubled during the same period. And he, like others, doesn’t expect any significant improvement until late in 2010.