- Associated Press - Wednesday, February 17, 2016

Recent editorials from West Virginia newspapers:

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Feb. 17

The Journal on chipping away at outdated or obsolete rules used by state agencies:

Without even looking at it, a state rule for “conduct of tree fruit industries self-improvement assessment program referendums” seems unnecessary. But West Virginia has such a rule on the books, along with a similar one for the beef industry.

With any luck, they and dozens of other unnecessary rules will be gone within a few weeks.

Members of the state Senate Judiciary Committee have forwarded eight bills intended to repeal more than 120 outdated or obsolete rules used by state agencies. If the full Legislature agrees, the red tape will be cut.

Business people frequently complain about the regulatory burden of doing business in the state. Many unnecessary laws - and sometimes, rules adopted by government agencies on their own - add to the cost and difficulty of creating and maintaining jobs in West Virginia.

Chipping away at such regulations - and make no mistake, repealing 120 of them is only that - may seem to some legislators like beating their heads against a bureaucratic brick wall.

But it is good, important work. Kudos to the Judiciary Committee for taking the time to make it just a little bit easier to do business in West Virginia.

Online:

http://journal-news.net

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Feb. 16

The Herald-Dispatch on proposal that could aid West Virginia’s minority communities:

Legislation aimed at addressing issues related to poverty in West Virginia’s minority communities breezed through the state legislature last year before hitting a brick wall in the form of a veto by Gov. Earl Ray Tomblin.

Now, backers of that bill - or one with essentially the same goal, at least - say they plan to give it another go in the current legislative session. It appears they may have made adjustments that shouldn’t jeopardize its chances in the House of Delegates and Senate but just might overcome the objections that the governor laid out last year.

The legislation’s purpose is to establish a pilot program in minority communities aimed at improving public health, including reducing child obesity and poverty, making educational improvements and creating economic development opportunities, according to a report by the Charleston Gazette-Mail.

Among other things, the pilot program would look at disparities among blacks and whites on various health-related and socio-economic factors, study the causes and seek solutions for addressing them, with the hope of strengthening those communities.

The new legislation would establish a Minority Health Advisory Team to lead the program, and Dr. Rahul Gupta, commissioner of the Bureau of Public Health, would oversee that group. The advisory team would be made up of experts on medical, public health, education and social services from institutions around the state.

In a period when state government is struggling to balance its budget, a strong selling point of the proposal is that it is not seeking any state or local funding, the Gazette-Mail reported. Instead, it is structured to leverage resources already at play in the communities that qualify and encourage their residents to participate.

Tomblin’s objections to last year’s bill had to do with two factors. One was that the program would be placed under the auspices of a state office that the governor said did not have adequate staffing and resources to take it on. He was correct about that. But the Bureau of Public Health should have the type of staffing power to provide adequate impetus to the project. The other objection was that the previous proposal for a pilot program was focused entirely on Charleston’s West Side. The governor believed - rightly so, in our opinion - that the potential benefits from the project should not be limited to one area, but be available statewide to areas that meet a set of standards for participation.

With those two reasonable objections dealt with, and a price tag that won’t add to the state budget deficit, this second try at providing assistance to minority communities should be able to gain approval from both the legislature and the governor.

Online:

http://www.herald-dispatch.com

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Feb. 16

The Exponent Telegram on West Virginia’s Medicaid reform:

One element of the Affordable Care Act, commonly known as Obamacare, that we have supported is the expansion of state-sponsored Medicaid to residents who earn up to 150 percent of the federal poverty level. We’ve also supported extension of the West Virginia Children’s Health Insurance Plan to cover youth under the age of 18 who live in households earning up to 200 percent of the federal poverty level.

Gov. Earl Ray Tomblin opted to expand Medicaid under the Affordable Care Act as of Jan. 1, 2014. The state is utilizing federal funds to provide Medicaid for the newly eligible population of low-income adults, most of whom have jobs but no option for employer-sponsored health insurance.

However, like everything else in life, there’s no such thing as a free lunch. Starting in 2017, the state will gradually begin to pay a percentage of the cost of expanded Medicaid coverage, though it will never exceed 10 percent.

Under the new eligibility guidelines under Obamacare, West Virginia’s Medicaid enrollment grew by nearly 193,000 between the fall of 2013 and October 2015, representing an increase of 54 percent.

That includes residents who were already eligible (but not yet enrolled) prior to 2014. But even if we only consider the Medicaid expansion population, enrollment had grown by 164,400 people as of the end of June 2015. That’s significantly more than the 93,000 people that West Virginia had projected to enroll by 2020.

Elected officials anticipated savings from a 2007 state Medicaid overhaul that was intended to generate more than enough in cost reductions to cover the state’s increased share of Medicaid costs due to the expansion. That was a very important financial consideration, considering the mess the state’s budget is in.

But a study released in January by the Health Research and Educational Trust, which examined West Virginia’s 2007 Medicaid program overhaul, has found that the state’s “nudging” plan to decrease emergency room visits backfired - an outcome that could affect how states approach lowering the cost of health care under the Affordable Care Act.

According the an article in the Charleston Gazette Mail, the study looked at the impact of the Mountain Health Choices program, which replaced traditional Medicaid plans with two types of plans: Basic plans, which offered less coverage than prior Medicaid plans, and advanced plans, which offered more coverage and required participants to agree to rules that were designed to improve health behaviors.

Consumers who opted for advanced plans were asked to sign a member agreement and follow a personalized health plan, while those with basic plans received far less extensive coverage, including a cap on prescriptions and no coverage for substance abuse services and inpatient mental health services.

Unfortunately, only 12 percent of participants have chosen an advanced plan through the Mountain Health Choices program. Also, the program saw an increase in emergency room visits among those who chose or were automatically enrolled in basic plans, as well as an increase in the average number of non-emergency ER visits for Medicaid recipients overall, despite a decrease among those who opted for an advanced plan.

Which simply proves that old habits are hard to break. We have trained generations of West Virginia Medicaid recipients to simply go to the hospital emergency room - the most expensive form of health care - when they need medical attention.

West Virginia’s Mountain Health Choices program was one of the most controversial, as it imposed coverage limits based on member behavior.

But assessing the impacts of such efforts is important as states continue to grapple with the goal of reducing costs without causing negative health impacts.

Everyone must take responsibility for his or her own health care choices. The key is that everyone must have some skin in the game. From those of us on private insurance to PEIA - we are all forced to make smart health care and lifestyle choices.

West Virginia Medicaid recipients must be held to similar standards.

Online:

http://www.theet.com

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