West Virginia spends more on its Medicaid program than any other single area of the state budget except for elementary and secondary education. Several state officials characterized the Medicaid program as an integral part of the West Virginia's health care system. It funds approximately 55 percent of the state's births. West Virginia's Medicaid program has been plagued with budget shortfalls. In general, the governor and legislature have been hesitant to cut coverage preferring instead to rely periodically on state funds set aside for changes in federal programs, funds from the state's tobacco tax, and attempts to control utilization. West Virginia has a Health Care Provider Tax that dates back to 1993. This tax continues to be a source of contention between the state and the various health care providers that are taxed.
The start-up and administration of West Virginia's SCHIP has been a source of contention. The state was slow to ramp up its SCHIP program due to problems inherent to starting a new program and fear that SCHIP would expand the state's already costly Medicaid program. From July 1998 to October 2000, West Virginia expanded its program to cover all children in households with income from 150 to 200 percent of the federal poverty level. SCHIP became a high profile item when Governor Bob Wise campaigned on a platform that included improving the program's enrollment. West Virginia's SCHIP program was one of only a few spared from the executive's directive to cut SFY 2005 state agency funding requests by 9 percent.
"report.pdf" (pdf, 1.52Mb)