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D.C. Dems extend Medicaid; states face bills

Politico reports that West Virginia Gov. Earl Ray Tomblin is the nation's only Democratic governor who has not supported the Medicaid expansion that's part of the new health care law.

At least not yet.

Each state must decide whether to join or opt out of the expansion of the health care program for the poor to include people making up to 133 percent of the poverty level. All but a half dozen states have decided, or are leaning one way or another.

Tomblin, however, remains non-committal even as his fellow governors choose sides, often along party lines.

"While seven Republican governors have so far bucked their party to back expansion, Tomblin has held firm," write Kyle Cheney and Jason Millman in Politico. "Not just firm, but silent."

Some governors are finding it hard to resist the money.

After all, the federal government will initially pay for all new Medicaid enrollees.  

However, other governors worry that when Washington begins scaling back its share - it drops to 90 percent in 2020 - it will strain their state budgets.

Tomblin is clearly wary of the Medicaid expansion, and for good reason.

This fiscal year, West Virginia will spend $857 million in state dollars - and $2.2 billion in federal money - to provide Medicaid coverage to about 415,000 West Virginians.

Next year, the state share will rise to close to $900 million and continue to increase in subsequent years, even before expansion.

Opting into the Medicaid expansion means about 130,000 more people will enroll in the program.

The rate of growth in spending will accelerate starting in 2020 because of the smaller federal match.

Additionally, it's possible that the federal share could be reduced further as Washington tries to get spending under control.

With West Virginia's coal industry softening, Tomblin is trying to keep a tight rein on the budget. There's no new spending planned for next year, except for Medicaid and to keep retirement programs actuarially sound.

And Tomblin is cutting spending in some areas of government by 7.5 percent.

Politico reports that Sen. Jay Rockefeller, a long-time advocate of expanded government health care, is confident Tomblin will eventually come on board.

"I've stayed in close touch with the governor's office through this process, and I know they are working to understand the details," Rockefeller told Politico.

"I think at the end of the day, the numbers will show that expansion would greatly benefit West Virginians."

Perhaps, but for now Tomblin is keeping his cards close to the vest, while his budget people try to figure out how much all this is going to cost.

Kercheval is host of TalkLine, broadcast by the MetroNews Statewide Radio Network from 10 a.m. to noon Monday through Friday. The show can be heard locally on WCHS 580 AM.



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