CHARLESTON, W.Va. - With the legislative session over, Gov. Earl Ray Tomblin is expected to announce whether the state will expand Medicaid as offered under Obamacare. Advocates say expansion would not be hard on West Virginia's state budget. The federal government would pay the full cost of expansion for three years and no less than 90 percent after that. Critics have warned the feds might not keep that promise, leaving the state on the hook.
However, Perry Bryant, executive director, West Virginians for Affordable Healthcare, said the White House fought to protect the program's funding in the recent budget battles.
"I think it shows you the commitment that President Obama is making to Medicaid, to make sure the governors know that as long as he's president the contribution that they've made to states in the Affordable Care Act is going to be upheld," he said.
The state budget will actually benefit from the economic activity sparked by $700 million in new federal Medicaid money, Bryant said. They estimate the new funding will mean 6,200 additional jobs by 2016, he added, and that will filter through to new revenue for the state, offsetting some of what expansion will cost.
"More nurses, more doctors," Bryant said. "They go to restaurants. They buy cars. All that generates economic activity. Clearly it will offset. Whether it will totally compensate for it or not, we don't know. "
One option being considered in Arkansas would give the new Medicaid patients vouchers to buy private insurance in the newly open insurance exchange. That would increase the reimbursement rates for doctors, Bryant said, meaning more providers would accept Medicaid, but it could cost the state more to cover the same patients, he warned.
"Increase reimbursements, you provide them the same benefits, you need to pay these insurance companies for providing those services," he said. "How you end up making that budget neutral, I just don't know."
Expanding Medicaid up to one and one-third times the poverty line would cover more than 100,000 low-income West Virginians. Critics have most often cited budget issues as their chief reservation.
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An initiative that would repeal Washington's capital-gains tax on the state's richest residents is struggling to gain traction.
Initiative No. 1929 would eliminate a 7% tax on stocks, bonds and other assets worth more than $250,000, which lawmakers approved in the 2021 session.
The tax is projected to bring in $415 million dollars for child care and education if it goes into effect in 2023.
Aaron Ostrom, executive director of the progressive organization Fuse Washington, said it would only be levied on a small number of people.
"These are people who own yachts and are looking to buy a second yacht," said Ostrom. "This is not just rich people, this is the ultra-wealthy who are looking to further rig a system that's already rigged in their favor at the expense of child care and early childhood education."
Supporters of I-1929 argue that the tax passed by the state Legislature last year is an income tax, which is unconstitutional in Washington state. A judge agreed in March and overturned the measure lawmakers passed last year.
Attorney General Bob Ferguson is appealing that decision to the Washington Supreme Court.
Organizers of I-1929 have until July 8 to collect about 325,000 signatures. Ostrom says they are far behind and have not even reached $1 million in donations for the campaign.
"The longer you wait, the more expensive it gets," said Ostrom. "So they would probably have to pay over $10 million to get on the ballot at this point, and they're not raising funds that are anywhere near that neighborhood and they're not showing any signs of actually starting to move into signature gathering."
Ostrom disagreed that the capital gains tax passed by lawmakers qualifies as an income tax.
"It's a tax on extraordinary capital gains for a tiny number of ultra-wealthy people," said Ostrom. "And Wall Street speculation is not the same thing as earning income."
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Gov. Tom Wolf, lawmakers and community leaders are calling on the General Assembly to pass legislation that would send checks of up to $2,000 to millions of Pennsylvanians.
Earlier this year, Wolf unveiled a $1.7 billion proposal aimed at helping communities recover from the pandemic through American Rescue Plan dollars.
Part of that plan includes the $500 million Pennsylvania Opportunity Program, which would provide direct payments for households with an income of $80,000 or less.
Wolf said with inflation climbing, more Pennsylvanians are experiencing financial insecurity.
"The problem is that far too many people live paycheck to paycheck," said Wolf. "And even now, with a small increase in living expenses - even if that's all people were facing with the inflation, that can have devastating consequences. Pennsylvanians deserve better and there are ways we can help."
Pennsylvania has $2.2 billion unused American Rescue Plan dollars that must be used by the end of 2024.
Democratic leaders in the state Senate and House have introduced legislation to support the Opportunity Program. Both were referred to the respective chamber's Finance Committee last month.
Wolf and legislative leaders also are continuing their calls to increase the state minimum wage, which is currently $7.25 per hour and has not had an increase since 2009.
State Rep. Patty Kim - D-Dauphin - has introduced a bill that would raise the minimum wage to $12 per hour by July and would reach $15 by 2028.
"If we learned anything from this pandemic, we need to go back to the basics," said Kim. "We need safe, affordable housing, we need good schools, we need a living wage, we need to value our workers and we need each other."
The Massachusetts Institute of Technology's Living Wage calculator shows that today, a single adult in Pennsylvania needs to earn nearly $17 per hour to support themselves - while a single adult with one child needs nearly $33 per hour to support their family.
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Advocates for juvenile-justice and child-welfare providers in Pennsylvania want the General Assembly to approve one-time funding to boost staff recruitment and retention to fight a labor-shortage crisis.
The Pennsylvania Council of Children, Youth and Family Services is requesting a $94.7 million infusion to support nearly 19,000 positions, both vacant and filled.
William Vogler, CEO of Pinebrook Family Answers, which offers adoption, foster care, kinship care and child-abuse prevention programs in the Lehigh Valley, said the staffing shortage hurts young people the most.
"If we don't have the people that are willing or able to drive kids to visits to see their biological families, or to engage with a foster family, help get kids to appointments, they simply don't get that service," Vogler explained.
Among the state's providers, 35% have a waiting list largely due to staff limitations, according to a council survey. Rep. Rosemary Brown, R-Monroe/Pike, and Rep. Carrie DelRosso, R-Allegheny, are asking for the funding to be part of the 2022-2023 fiscal year budget, which must be finalized by June 30.
Janna Brubaker, executive director of Families United Network, a child-welfare provider offering foster care, kinship care, adoption and residential services in most Pennsylvania counties, said part of the challenge is providers have to plan ahead with county agencies to set reimbursement rates.
"We cannot just change our rates based on the cost of doing business," Brubaker argued. "We actually have to evaluate our rates almost 18 months in advance. It's difficult to compete against Walmart or Amazon that are offering over $20 an hour. We can't do that."
Brubaker added Families United Network increased its wages during the pandemic, but still averages a 15% to 20% job vacancy rate. She thinks some increased funding could be used to provide bonuses, both for new and longtime staff.
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