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WV Medicaid Insurance “Redesign” to be Redesigned Again?

June 12, 2008

Charleston, WV – West Virginia's "redesign" of Medicaid insurance, called "Mountain Health Choices," isn't doing what it was intended to, according to a new report from FACES on Medicaid, a coalition of organizations that wants to see state health care reform.

Two years after the rollout, the report says, most who are using the insurance coverage don't understand the changes, and find themselves enrolled in the "basic" plan, which limits doctor prescriptions and preventive care. Some are eligible for "enhanced" coverage, but may not realize they have to sign up for it specifically.

The goal was to encourage more personal responsibility. However, Sam Hickman with the National Association of Social Workers West Virginia Chapter thinks the information has been unclear - and it catches families by surprise when trying to manage chronic health conditions.

"Something's wrong here. These are the neediest of our West Virginia citizens and, by far, the vast majority are children. Have they made a conscious decision to do that? I don't think so."

The report suggests the state rework the program once again. Hickman says the suspension of "Mountain Health Choices" would be temporary, with more changes expected as part of the bigger debate on how West Virginia will reform healthcare. In the meantime, he explains, the state could switch back to regular Medicaid coverage.

"As other states have done, notably Vermont and Massachusetts, Medicaid will be part of finding ways to provide health coverage for people who currently have no access to health care insurance."

State leaders who back the current program say the low number of signups for enhanced coverage show that the redesign is working.

Deborah Smith/Don Mathisen, Public News Service - WV