On Wellness in WV

Sometimes you can can learn a lot about someone by what they don’t say.

On July 15, we published a story I wrote about how a plan the U.S. Senate was considering to repeal and replace the Affordable Care Act would cause West Virginians to lose access to addiction treatment.

The story noted that the bill would end Medicaid expansion in West Virginia and make deep cuts to traditional Medicaid. It noted that in 2016, about 50,000 of those covered by Medicaid expansion in West Virginia had substance-use disorders, according to the Department of Health and Human Resources.

From the story:

The Congressional Budget Office hasn’t released an estimate for the newest version of the bill. But it estimated the similar previous version would cut Medicaid by $772 billion over 10 years, based mainly on ending the extra funding for states that expanded Medicaid under the Affordable Care Act and setting per-capita-based caps on traditional Medicaid payments to states. It estimated 15 million fewer people would have Medicaid in 10 years.

Medicaid is the single largest payer of substance abuse and mental health treatment in the country. Nationwide, Medicaid covered three in 10 people with opioid addiction in 2015, according to the Kaiser Family Foundation. West Virginia has the highest overdose death rate in the nation, mainly due to opioids.

The newest version of the bill could also make obtaining coverage harder for people who have been addicted to opioids to find coverage on the private market because it would allow insurers to sell plans that discriminate against people with pre-existing conditions by charging higher rates.

Dr. James Berry, addiction psychiatrist and medical director at West Virginia University’s Chestnut Ridge Center, said the bill would be “devastating to the people who don’t have the financial resources in order to take advantage of programs such as ours.”

Lois Vance, addiction care coordinator at Kanawha City Health Center, said “If they lose their insurance, the whole world is going to be looking down on them again.”

And from a previous story:

Medicaid expansion money spent on substance abuse treatment, including services and prescriptions, increased from about $25 million in 2014 to $111,767,057 in 2016.

In 2013, 5,827 people with opioid abuse diagnoses were covered by Medicaid, according to the DHHR. Medicaid paid for $6.8 million in opioid abuse-related claims that year. By 2016, the number had increased to 14,808 patients. Medicaid paid for more than $17 million in opioid abuse-related claims that year.

All three members of the U.S. House of Representatives — Reps. David McKinley, Alex Mooney, and Evan Jenkins, all Republicans — voted for a bill that would have similarly resulted in a loss of coverage among the opioid-addicted population in West Virginia. It would have cut Medicaid by an estimated $834 billion over 10 years, resulting in 14 million fewer Medicaid enrollees by 2026, the Congressional Budget Office found. States would also have been allowed not to require insurers to cover certain conditions, including mental health and substance abuse problems.

Spokesmen for Mooney and McKinley have not responded to requests for comment on how their votes could have affected the opioid-addicted population in West Virginia. Those requests were sent July 17, following the release of the latest story.

A spokeswoman for Jenkins responded to the initial request, but never sent a statement or set up an interview as requested.