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West Virginia needs a grown-up discussion on Medicaid spending

The drive along Kanawha Boulevard after the region's first snow sugar-coated the trees was another reminder of how wondrous it is to live in a state that is three-quarters forest.

Add to that Appalachian snow the blue and gold-leaf dome of our magnificent Capitol and you have a beauty that rivals any place on Earth.

West Virginia should do all it can to maximize this beauty, however, the reality is the state does the minimum to get by.

Legislators devote less than 1 percent of the state's general fund to the state park system.

When placed in the perspective of the entire state budget of $10 billion, including federal funds transferred to the state, that's four-tenths of 1 percent of taxpayer money.

Where does the other 99.6 percent of the money go?

Not to prisons. The state spends about $170 million a year on corrections, which is 4 percent of the general fund or less than 2 percent of the overall state spending.

But legislators keep carping on prison costs as they work to reduce spending on prisons.

Name a function of state government and there is a need to spend more money, but there are exceptions.

Highways get hefty funding, but after paying more than 50 cents a gallon in state and federal taxes, drivers expect roads cleared of snow in the winter and potholes in the spring.

Taxpayers support education; West Virginia beats the national average on spending per student. Also, taxpayers spend nearly a half-billion dollars a year to shore up the nation's most underfunded teacher pension plan. A promise is a promise, so that funding must continue.

But politicians can and should slow down the fastest growing expense in the state budget: Medicaid, which chews up $2.7 billion a year and is climbing.

That is one-fourth of the state's overall spending.

A combination of liberals, hospitals, nursing homes and Congress have bullied state taxpayers into ponying up more than $800 million a year for a program that covers the medical bills of 400,000 of the state's 1.8 million residents.

Some of the state's money comes from a provider's tax, which is really a tax on patients as the state soaks the sick.

For every dollar the state puts up, Congress puts up three, thus the incentive to divert money from other programs into Medicaid.

The $800 million a year that state taxpayers spend on Medicaid generates $2.7 billion for the state economy, but that $800 million annual gift to the medical industry also means the state cannot fully fund its more basic services that benefit all.

Consider Child Protective Services, which is unable to fully protect children because the agency is understaffed because it is underfunded.

Liberals point out that half the people covered by Medicaid are children. Fine. Keep them. Children are relatively inexpensive to insure. For the most part, they have not lived long enough to contract cancer, diabetes, heart disease and the like.

But why are we providing first-dollar coverage without a co-payment, deductible or premium to 200,000 adults?

If government employee health plans are Cadillac plans, then Medicaid is a Bentley. And a chauffeured Bentley at that, as Medicaid pays millions every year to emergency services agencies across the state to drive Medicaid patients to the doctor and the like.

To save the rest of state government, West Virginia must discuss Medicaid funding, in an adult manner, without histrionics about wheeling granny off the cliff.

As any drive along the Boulevard on a winter's morn, spring day, autumn afternoon or summer night will confirm, West Virginia is beautiful and has a magnificent Capitol. It's time the policy makers under that gold-leafed Dome better protected that beauty.


Surber is an editorial writer. His email is



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