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The latest on the Key Bridge collapse, New York puts forth legislation to get clean energy projects on the grid and Wisconsin and other states join a federal summer food program to help feed kids across the country.

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Analysis: WV Medicaid Expansion Would Save State Budget Millions

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Wednesday, February 13, 2013   

CHARLESTON, W.Va. - Gov. Earl Ray Tomblin is considering opening the Medicaid system to many of the working poor, an option under 2010's health-care reform.

Some are concerned about the future cost, but close observers of health-care finance believe expansion will actually save taxpayers millions. It may sound contradictory, said Senate President Jeff Kessler, D-Charleston, but the budget will be improved by reducing the unpaid emergency-room care for people who are now uninsured.

"Those folks will still be seen; we don't throw them out on the street to die," Kessler said. "They end up getting treated, and usually in an uncompensated care setting. It's not a very efficient way to deliver medical services."

Separate changes in federal payments for current Medicaid patients mean the state's program faces a $160 million shortfall, moving some to oppose expansion. But according to the Urban Institute, covering 130,000 uninsured folks will save the state millions overall.

Joe Letnaunchyn, president and chief executive of the West Virginia Hospital Association, said reducing uncompensated care will make the system work better for everyone, including taxpayers.

"We have people receiving care where they should receive it, when they should receive it. We have a more organized health care delivery system, because we have fewer people in the emergency departments."

Letnaunchyn said some savings will come from turning sick, uninsured folks into taxpayers.

"They get healthier, go into the workforce and off the Medicaid rolls," he said, "and they're providing an economic benefit within the state because they become taxpayers."

West Virginia hospitals now give $740 million worth of uncompensated care every year, which he said is part of the reason half are losing money. They may continue to lose money on a new Medicaid patient, Letnaunchyn said, but the loss would be smaller than on someone receiving uncompensated care.

"And then take Joe, who then goes in for the same procedure and gets a payment from Medicaid, which still might be less than cost, but it's more than zero," he said.

Once the complex math becomes clear, Kessler said, the expansion could be a no-brainer. He said that's why Ohio's Republican governor, John Kasich, approved expansion there.

The Urban Institute study is online at urban.org.


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