Putting Medicaid in the Larger Budget Context: An In-Depth Look at Four States in FY 2014 and 2015

Michigan
  1. “Regional and State Employment and Unemployment Archived News Releases”, United States Department of Labor, Bureau of Labor Statistics website, Accessed September 16, 2014.

    http://www.bls.gov/schedule/archives/laus_nr.htm#2014

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  2. “Monthly Revenue Report” Michigan Senate Fiscal Agency website, Accessed September 16, 2014. http://www.senate.michigan.gov/sfa/Publications/MonthRev/monthrev.html.

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  3. “ Regional and State Employment and Unemployment Archived News Releases”, United States Department of Labor, Bureau of Labor Statistics website, Accessed September 16, 2014.

    http://www.bls.gov/schedule/archives/laus_nr.htm#2014

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  4. Michigan Senate Fiscal Agency, Annual Appropriations Report, FY 1999-2000 through FY 2014-15, http://www.senate.michigan.gov/sfa/Publications/Approps/appropsreports.html

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  5. Michigan Senate Fiscal Agency, A Summary of Quality Assurance Assessment Programs, http://www.senate.michigan.gov/sfa/Publications/Notes/2007Notes/NotesJulAug07df.pdf.

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  6. Michigan Senate Fiscal Agency, Annual Appropriations Report, FY 1999-2000 through FY 2014-15, http://www.senate.michigan.gov/sfa/Publications/Approps/appropsreports.html

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  7. “Michigan Department of Community Health: Senate Bill 763 Decision Document”, Michigan Senate Fiscal Agency website, September 16, 2014. http://www.senate.michigan.gov/sfa/Departments/DecisionDoc/DDdch_web.pdf.

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  8. Kaiser Commission on Medicaid and the Uninsured, How Will the Uninsured in Michigan Fare Under the Affordable Care Act? (Kaiser Family Foundation, January 2014.) https://www.kff.org/health-reform/fact-sheet/state-profiles-uninsured-under-aca-michigan/.

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  9. State Health Facts, State Decisions for Creating Health Insurance Marketplaces. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/state-decisions-for-creating-health-insurance-marketplaces/.

    State Marketplace Profiles: Michigan. (Kaiser Family Foundation, November 2013.) https://www.kff.org/health-reform/state-profile/state-exchange-profiles-michigan/.

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  10. State Health Facts, Total Number of Insurers Participating in the Individual Health Insurance Marketplace. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/total-number-of-insurers-participating-in-the-individual-health-insurance-marketplace/.

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  11. State Health Facts, Marketplace Enrollment as a Share of the Potential Marketplace Population. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/marketplace-enrollment-as-a-share-of-the-potential-marketplace-population/.

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  12. State Health Facts, Marketplace Enrollees by Financial Assistance Status. (Kaiser Family Foundation), https://www.kff.org/other/state-indicator/marketplace-enrollees-by-financial-assistance-status/.

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  13. “Executive Budget Fiscal Years 2014 and 2015”, Michigan Department of Management and Budget website, Accessed September 16, 2014. http://www.michigan.gov/documents/budget/1_410735_7.pdf?20140916114722.

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  14. “FY 2013-14 Appropriation Report Department of Community Health, Public Act 59 of 2013, FY 2012-13 and FY 2013-14 Supplemental Actions to Date”, ,Michigan House Fiscal Agency website, Accessed September 16, 2014 http://house.mi.gov/hfa/PDF/CommunityHealth/DCH_Intent_Document_fy13-14.pdf.

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  15. Per an October 2014 interview with officials of the Medical Services Administration, the Healthy Behaviors Protocol includes a goal that the appointment is completed within 150 days of enrollment.

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  16. MCO enrollment is optional for Native Americans and others that meet the state’s Medicaid health plan exemption criteria.

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  17. “House Bill 4714 (2013)”, Michigan Legislative Website, Accessed September 16, 2014. http://www.legislature.mi.gov/(S(wz0uga55dk5zbu55itnhm155))/mileg.aspx?page=getObject&objectName=2013-HB-4714.

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  18. Ibid.

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  19. “Healthy Michigan Plan, A Waiver Amendment Request Submitted Under Authority of Section 1115 of the Social Security Act”, Michigan Department of Community Health website, Accessed September 16, 2014.

    http://www.michigan.gov/documents/mdch/Healthy_Michigan_Waiver_Amendment_for_Web_439514_7.pdf

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  20. “House Bill 4714 (2013)”, Michigan Legislature website, Accessed September 16, 2014.

    http://www.legislature.mi.gov/documents/2013-2014/billanalysis/Senate/pdf/2013-SFA-4714-F.pdf.

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  21. “Healthy Michigan Plan Applicant Information”, Michigan Department of Community Health website, Accessed September 8, 2014.

    http://www.michigan.gov/mdch/0,4612,7-132-2943_66797---,00.html.

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  22. “Multi-Payer Advanced Primary Care Practice.” Centers for Medicare and Medicaid Services – Innovation Center website. Accessed September 2014. http://innovation.cms.gov/initiatives/Multi-Payer-Advanced-Primary-Care-Practice/.

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  23. “About MiPCT”, Michigan Primary Care Transformation Project website, Accessed September 16, 2014. http://mipct.org/about-us/.

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  24. “State Innovation Models Initiative Round 2 Fact Sheet.” Centers for Medicare and Medicaid Services - Innovation Center, May 22, 2014.) http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-05-22.html.

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  25. “Reinventing Michigan’s Health Care System, Blueprint for Health Innovation”, Michigan Department of Community Health website, Accessed September 16, 2014.

    http://www.michigan.gov/documents/mdch/Michigan_Blueprint_APPENDICES_REMOVED_454499_7.pdf.

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  26. “State Innovation Models Initiative Round 2 Fact Sheet.” Centers for Medicare and Medicaid Services - Innovation Center, May 22, 2014.) http://www.cms.gov/Newsroom/MediaReleaseDatabase/Fact-sheets/2014-Fact-sheets-items/2014-05-22.html

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  27. As of June 2014, CMS had not yet approved this state plan amendment, but the state had state legislation calling for implementation to begin July 2014.

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  28. “Health Homes”, Michigan Department of Community Health website, Accessed September 16, 2014.

    http://www.michigan.gov/mdch/0,4612,7-132-2941_58005-251825--,00.html.

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  29. “Integrated Care for People Eligible for Medicare and Medicaid”, Michigan Department of Community Health website, Accessed September 14, 2014. http://www.michigan.gov/mdch/0,4612,7-132-2939__2939__2939-259203--,00.html.

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  30. Populations included in the demonstration are: full benefit dual eligible beneficiaries age 21 and older are eligible to enroll; those enrolled in the MI Choice § 1915(c) HCBS wavier, Money Follows the Person, PACE, or an employer-sponsored Medicare Advantage plan may participate if they disenroll from their existing program. The demonstration excludes the following populations: dual eligible beneficiaries previously disenrolled from Medicaid managed care due to uncooperative or disruptive behavior, those who are eligible as Additional Low Income Medicare Beneficiaries/Qualified Individuals or through a Medicaid spend down, state psychiatric hospital residents, those with commercial HMO coverage, and those who elect hospice services.

    MaryBeth Musumeci, Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS, (Kaiser Family Foundation, July 24, 2014.) https://www.kff.org/report-section/financial-and-administrative-alignment-demonstrations-for-dual-eligible-beneficiaries-compared-appendix-michigan/.

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  31. Beneficiaries subject to Medicare reassignment effective January 1, 2015 will not be passively enrolled in the demonstration in 2015 but will be eligible for passive enrollment in 2016.

    MaryBeth Musumeci, Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS, (Kaiser Family Foundation, July 24, 2014.) https://www.kff.org/report-section/financial-and-administrative-alignment-demonstrations-for-dual-eligible-beneficiaries-compared-appendix-michigan/.

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Utah
  1. U.S Bureau of Labor Statistics; Labor Force Statistics from the Current Population Survey; Accessed at: http://www.bls.gov/cps/.

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  2. Census Bureau; State Government Tax Collections SFY 2008-2013; Access September 22, 2014 at: http://www.census.gov/govs/statetax/index.html.

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  3. National Association of State Budget Officers; The Fiscal Survey of the States: Fall 2008; December 2008. The Fiscal Survey of the Sates: Fall 2013; Accessed at: http://www.nasbo.org/publications-data/fiscal-survey-of-the-states/archives.

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  4. National Association of State Budget Officers; The Fiscal Survey of the States: Fall 2010; Table 26; Accessed at: http://www.nasbo.org/publications-data/fiscal-survey-of-the-states/archives.

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  5. National Association of State Budget Officers; The Fiscal Survey of the States: Fall 2011; Table 30; Accessed at: http://www.nasbo.org/publications-data/fiscal-survey-of-the-states/archives.

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  6. U.S Bureau of Labor Statistics; Labor Force Statistics from the Current Population Survey; Accessed at: http://www.bls.gov/cps/.

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  7. Salt Lake Chamber; Utah ranked top pro-business state three years running; Report on Pollina Top 10 Pro-Business Study; July 17, 2014; Accessed at: http://slchamber.com/blog/category/chamber-news/utah-rankings.

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  8. Michael B. Sauter, Thomas C. Frohlich et.al; Best and Worst Run States: A 50 State Survey; 24/7 Wall Street; November 23, 2013; Accessed at: http://www.usatoday.com/story/money/business/2013/11/22/best-worst-run-states/3671359/.

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  9. U.S Bureau of Labor Statistics; Unemployment Rates for States Average Annual Rankings Year 2013

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  10. Governor Gary R. Herbert; Budget Recommendations: Fiscal Year 2015 Fiscal Year 2014 Supplementals; Accessed at: http://www.utah.gov/governor/docs/budget/FY2014_2015_Recommendations.pdf.

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  11. Utah Constitution, Article XIII Section 5; http://le.utah.gov/code/CONST/htm/00I13_000500.htm.

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  12. http://le.utah.gov/interim/2014/pdf/00003542.pdf.

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  13. Governor’s Office of Management and Budget; Overview of SUCCESS; Accessed at: http://gomb.utah.gov/operational-excellence/overview-of-success/.

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  14. Governor Gary R. Herbert; Budget Recommendations: Fiscal Year 2015 Fiscal Year 2014 Supplementals; Accessed at: http://www.utah.gov/governor/docs/budget/FY2014_2015_Recommendations.pdf.

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  15. Ibid.

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  16. Henry J. Kaiser Family Foundation; State Health Facts; Federal Medical Assistance Percentage (FMAP) and Multiplier; 2013 and 2015; Accessed at: https://www.kff.org/state-category/medicaid-chip/.

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  17. Kaiser Commission on Medicaid and the Uninsured; The Utah Health Care Landscape; Fact Sheet; September 2014. https://www.kff.org/health-reform/fact-sheet/the-utah-health-care-landscape/.

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  18. National Federation of Independent Business v. Sebilius; June 28, 2012.

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  19. Kaiser Commission on Medicaid and the Uninsured; Status of State Action on the Medicaid Expansion Decision; As of August 28, 2014.

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  20. Utah Governor’s Office of Economic Development: Office of Consumer Health Services website: http://business.utah.gov/programs/ochs/.

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  21. Gary Cohn, Director, CMS Center for Consumer Information and Insurance Oversight; Letter to Governor Gary Herbert; May 10, 2013; Accessed at: https://www.cms.gov/CCIIO/Resources/Fact-Sheets-and-FAQs/Downloads/utah-marketplace-letter-5-10-2013-508.pdf.

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  22. State Health Facts, Total Number of Insurers Participating in the Individual Health Insurance Marketplace. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/total-number-of-insurers-participating-in-the-individual-health-insurance-marketplace/.

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  23. State Health Facts, Marketplace Enrollment as a Share of the Potential Marketplace Population. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/marketplace-enrollment-as-a-share-of-the-potential-marketplace-population/.

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  24. State Health Facts, Marketplace Enrollees by Financial Assistance Status. (Kaiser Family Foundation), https://www.kff.org/other/state-indicator/marketplace-enrollees-by-financial-assistance-status/.

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  25. Governor’s Monthly News Conference, (KUED7, January 24, 2014) http://www.kued.org/video/governors-monthly-news-conference-january-2014.

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  26. Utah Governor Gary Herbert, “Governor unveiled an alternative plan to Medicaid expansion - The ‘Healthy Utah Plan’ fixes the hole without expanding Medicaid” (February 27, 2014), http://www.utah.gov/governor/news_media/article.html?article=9747.

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  27. Utah Department of Health, Healthy Utah Principles and Strategies: Update on CMS Discussions, (Presentation to Utah Health Reform Taskforce, August 28, 2014.) http://le.utah.gov/interim/2014/pdf/00004059.pdf.

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  28. Lisa Riley Roche, “Herbert reaches understanding ‘conceptually’ on Medicaid expansion” (Deseret News, September 9, 2014), http://www.deseretnews.com/article/865610609/Herbert-reaches-understanding-conceptually-on-Medicaid-expansion.html.

    Kristen Moultan, The Salt Lake Tribune; Utah Gov. Gary Herbert: We have a “conceptual” deal on Medicaid; September 10, 2014; Accessed at: http://www.sltrib.com/sltrib/news/58395005-78/utah-health-herbert-medicaid.html.csp?.

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  29. “Healthy Utah Negotiations Moving Forward.” Utah Governor Gary Herbert (September 17, 2014.) http://blog.governor.utah.gov/2014/09/healthy-utah-negotiations-moving-forward/.

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  30. “Non-traditional” Medicaid adults eligible through 1925 and 1931 TANF-related pathways, and medically needy non-ABD recipients.

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  31. Utah Department of Health, Medicaid Managed Care website: accessed at: https://medicaid.utah.gov/managed-care.

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  32. Utah response to the 2014 Medicaid Budget Survey for State Fiscal Years 2014 and 2015, Kaiser Commission on Medicaid and the Uninsured.

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Virginia
  1. Bureau of Economic Analysis, Quarterly Gross Domestic Product by State, (Department of Commerce.) Accessed August 2014. http://www.bea.gov/regional/index.htm.

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  2. Bureau of Economic Analysis, State Personal Income, (Department of Commerce.) Accessed August 2014. http://www.bea.gov/regional/index.htm.

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  3. Bureau of Labor Statistics, Local Area Unemployment Statistics, (Department of Commerce.) Accessed August 2014. http://data.bls.gov/timeseries/LASST510000000000003.

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  4. Virginia Department of Taxation, The Economic Outlook and Revenue Forecast through Fiscal Year 2016, (for review by the Governor’s Advisory Council on Revenue Estimates, November 25, 2013.) http://finance.virginia.gov/media/1791/2013NovemberGACRE.pdf.

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  5. Virginia Department of Taxation, The Economic Outlook and Revenue Forecast through Fiscal Year 2016, (for review by the Governor’s Advisory Council on Revenue Estimates, November 25, 2013.) http://finance.virginia.gov/media/1791/2013NovemberGACRE.pdf.

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  6. Timberlake, Daniel S. Governor McAuliffe’s Proposed Biennial Budget for the 2014-2016 Biennium HB/SB 5003, (Virginia Department of Planning and Budget, March 2014.) http://www.dpb.virginia.gov/forms/20140324-1/BudgetDirectorsPresentationHB-SB5003.pdf.

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  7. Office of the Governor, Governor McAuliffe’s Address to the Joint Money Committees of the General Assembly, (State of Virginia, August 15, 2014.) https://governor.virginia.gov/news/newsarticle?articleId=5800.

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  8. Virginia Department of Taxation, The Economic Outlook and Revenue Forecast through Fiscal Year 2018, (for review by the Governor’s Advisory Council on Revenue Estimates, August 1, 2014.) http://finance.virginia.gov/media/3045/aug-2014-gacre-book.pdf.

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  9. Brown, Richard D. Review of General Fund Revenues and the Virginia Economy for Fiscal Year 2014 The Interim Economic Outlook and Revenue Forecast for Fiscal Years 2015 through 2016: A Presentation to the Senate Finance, House Appropriations, and House Finance Committees, (Virginia Department of Finance, August 15, 2014.) http://finance.virginia.gov/media/3044/rdb-jmc-presentation-w-appendix-8-15-14.pdf.

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  10. Office of the Governor, Virginia Leaders Announce Comprehensive Budget Deal, (State of Virginia, September 15, 2014.) https://governor.virginia.gov/newsroom/newsarticle?articleId=6472.

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  11. Ibid.

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  12. Kaiser Commission on Medicaid and the Uninsured, How Will the Uninsured in Virginia Fare Under the Affordable Care Act? (Kaiser Family Foundation, January 2014.) https://www.kff.org/health-reform/fact-sheet/state-profiles-uninsured-under-aca-virginia/.

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  13. National Federation of Independent Business v. Sebilius; June 28, 2012.

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  14. Virginia’s eligibility level for 1931 parents varies by region, the 41% FPL reflects a weighted average of these three eligibility levels.

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  15. DMAS staff analysis using Urban Institute and Kaiser Commission on Medicaid and the Uninsured estimates based on the Census Bureau's March 2011 and 2012 Current Population Survey (CPS: Annual Social and Economic Supplements).

    An additional 123,000 Virginians with incomes between 100 and 138%FPL who may currently have Marketplace coverage would also qualify for Medicaid coverage if the state were to expand. These estimates differ slightly from estimates put forward by the state of Virginia for its Marketplace Virginia plan, which estimated up to 400,000 individuals that the state would be able to provide subsidies using federal Medicaid funds to purchase private health insurance. The main difference is that the state estimates include some individuals who are currently covered through other programs, such as pregnant women covered through the state’s CHIP program.

    Kaiser Commission on Medicaid and the Uninsured, The Virginia Health Care Landscape. (Kaiser Family Foundation, May 2014.) https://www.kff.org/medicaid/fact-sheet/the-virginia-health-care-landscape/#endnote_link_112148-70.

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  16. State Health Facts, State Decisions for Creating Health Insurance Marketplaces. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/state-decisions-for-creating-health-insurance-marketplaces/

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  17. State Health Facts, Total Number of Insurers Participating in the Individual Health Insurance Marketplace. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/total-number-of-insurers-participating-in-the-individual-health-insurance-marketplace/.

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  18. State Health Facts, Marketplace Enrollment as a Share of the Potential Marketplace Population. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/marketplace-enrollment-as-a-share-of-the-potential-marketplace-population/.

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  19. State Health Facts, Marketplace Enrollees by Financial Assistance Status. (Kaiser Family Foundation), https://www.kff.org/other/state-indicator/marketplace-enrollees-by-financial-assistance-status/.

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  20. Luke Johnson, Virginia Medicaid Expansion Got a Boost with Terry McAuliffe’s Win, But Republicans are Still Against It,” Huffington Post, November 6, 2013, accessed at http://www.huffingtonpost.com/2013/11/06/virginia-medicaid-expansion_n_4227921.html.

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  21. Office of the Governor, Governor McAuliffe Announces Proposed Budget Amendments, (State of Virginia, January 20, 2014.) https://governor.virginia.gov/news/newsarticle?articleId=2694.

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  22. Medicaid Innovation and Reform Commission, About the Commission, (Virginia General Assembly.) Accessed August 2014. http://mirc.virginia.gov/about.html.

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  23. In addition, the original plan included a provision for incentives related to work and job search activity, though the detail of this provision was not further defined as part of the proposal.

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  24. Senate Finance Committee, Marketplace Virginia Presentation, (Virginia Senate, February 2014.) http://sfc.virginia.gov/pdf/committee_meeting_presentations/2014/020614_Marketplace_Virginia_Briefing.pdf .

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  25. Speaker Bill Howell, Leadership Statement on Medicaid Expansion Proposal, (General Assembly, February 2014.) http://www.williamjhowell.org/house-leadership-statement-on-medicaid-expansion-proposal/.

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  26. Office of the Governor, Governor McAuliffe’s Letter to the General Assembly Following Adjournment, (State of Virginia, March 8, 2014.) https://governor.virginia.gov/news/newsarticle?articleId=3583.

    Timberlake, Daniel S. Governor McAuliffe’s Proposed Biennial Budget for the 2014-2016 Biennium HB/SB 5003, (Virginia Department of Planning and Budget, March 2014.) http://www.dpb.virginia.gov/forms/20140324-1/BudgetDirectorsPresentationHB-SB5003.pdf

    Office of the Governor, Governor McAuliffe Releases FY2015-16 Budget as Special Session Begins, (State of Virginia, March 24, 2014.) https://governor.virginia.gov/news/newsarticle?articleId=3650.

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  27. Speaker Bill Howell, Speaker Howell Letter to McAuliffe, (General Assembly, March 5, 2014.) http://www.williamjhowell.org/speaker-howell-letter-to-mcauliffe/.

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  28. Office of the Governor, Governor McAuliffe’s Statement on the Budget Impasse, (State of Virginia, April 11, 2014.) https://governor.virginia.gov/news/newsarticle?articleId=3854.

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  29. Around this same time, concerns were raised by some that the Governor may attempt to implement the Medicaid expansion without legislative approval. Republican leadership in the House of Delegates released a legal analysis prepared by Paul D. Clement, who represented plaintiffs in the ACA Supreme Court case, NFIB vs. Secretary Sebelius, and others which argued that the Governor did not have the authority to implement the Medicaid expansion without legislative action. Vozzella, Laura, “McAuliffe explores whether he can expand Medicaid coverage without legislature’s okay.” (Washington Post, May 1, 2014.) http://www.washingtonpost.com/local/virginia-politics/mcauliffe-explores-whether-he-can-expand-medicaid-coverage-without-legislatures-okay/2014/05/01/8ff591f2-d090-11e3-b812-0c92213941f4_story.html.

    Vozzella, Laura. “Virginia’s McAuliffe has begun planning for Medicaid expansion.” (Washington Post, June 4, 2014.) http://www.washingtonpost.com/blogs/govbeat/wp/2014/06/04/virginias-mcauliffe-has-begun-planning-for-medicaid-expansion/

    Speaker Bill Howell, Speaker Howell rules McAuliffe Vetoes Out of Order, (General Assembly, June 23, 2014.) http://www.williamjhowell.org/speaker-howell-rules-mcauliffe-vetoes-out-of-order/.

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  30. Office of the Governor, Statement of Governor Terence McAuliffe on 2015-2016 Budget Actions, (State of Virginia, June 20, 2014.) https://governor.virginia.gov/news/newsarticle?articleId=5216.

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  31. Speaker Bill Howell, Speaker Howell rules McAuliffe Vetoes Out of Order, (General Assembly, June 23, 2014.) http://www.williamjhowell.org/speaker-howell-rules-mcauliffe-vetoes-out-of-order/.

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  32. Office of the Governor, Governor McAuliffe Statement on General Assembly Actions on His Vetoes, (State of Virginia, June 23, 2014.) https://governor.virginia.gov/news/newsarticle?articleId=5242.

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  33. A Healthy Virginia Health Care Report. (Commonwealth of Virginia, September 8, 2014.) https://governor.virginia.gov/media/3096/a-healthy-virginia-report-final.pdf.

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  34. This comes after legislation was passed in August 2014 that provides new federal funding for the VA system including emergency spending to pay private providers to help address access issues in the VA system.

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  35. "Lawmakers Divided on McAuliffe's "Healthy VA" Plan," (WVIR-TV NBC News, September 9, 2014. http://www.nbc29.com/story/26489641/lawmakers-divided-on-mcauliffes-healthy-va-plan.

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  36. Speaker Bill Howell, House and Senate to debate Medicaid expansion in September, (General Assembly, July 9, 2014.) http://www.williamjhowell.org/house-and-senate-to-debate-medicaid-expansion-in-september/.

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  37. On December 1, 2014, Majestacare (Carillion) will suspend participation as a Medicaid MCO. This will leave six participating plans.

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  38. Department of Medical Assistance Services, Ten Things You Need To Know About Virginia Medicaid Managed Care Program, (State of Virginia.) http://www.dmas.virginia.gov/Content_atchs/mc/10ThingsMEDALLION3.pdf.

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  39. Department of Medical Assistance Services, Expedited Enrollment Fact Sheet, (State of Virginia.) http://www.dmas.virginia.gov/Content_atchs/mc/EE%20Fact%20Sheet%20080114.pdf.

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  40. Department of Medical Assistance Services, Commonwealth Coordinated Care Update – August 2014. (State of Virginia, August 2014.) http://dmasva.dmas.virginia.gov/Content_atchs/altc/August%20Update%20to%20CCC%20Stakeholders.pdf.

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  41. Musumeci, MaryBeth, Financial and Administrative Alignment Demonstrations for Dual Eligible Beneficiaries Compared: States with Memoranda of Understanding Approved by CMS, (Kaiser Family Foundation, July 2014.) https://www.kff.org/medicaid/issue-brief/financial-alignment-demonstrations-for-dual-eligible-beneficiaries-compared/.

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  42. Includes Virginia’s responses to the 2014 Medicaid Budget Survey for State Fiscal Years 2014 and 2015, Kaiser Commission on Medicaid and the Uninsured.

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  43. In addition, income eligibility for FAMIS MOMS (coverage for pregnant women through CHIP) was terminated effective January 1, 2014. The state plans to reverse this change, reinstating the program to 200% FPL and is seeking approval from CMS to amend the waiver. This is a CHIP-related change and is therefore not included in this report, which is focused on Medicaid.

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West Virginia
  1. U.S. Bureau of Economic Analysis, Widespread But Slower Growth in 2013, June 11, 2014, accessed at http://www.bea.gov/newsreleases/regional/gdp_state/gsp_newsrelease.htm.

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  2. Ted Boettner, Why is West Virginia GDP Up and Employment is Down? Fracking?, West Virginia Center on Budget and Policy Blog, July 1, 2014 post, accessed at http://www.wvpolicy.org/why-is-west-virginia-gdp-up-and-employment-down-fracking.

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  3. WorkForce West Virginia, Review of Economic Activity in 2013, June 2104, accessed at http://www.workforcewv.org/lmi/datarel/AnnualAverages.html.

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  4. Ibid.

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  5. West Virginia Executive Budget, Fiscal Year 2015, Volume I Budget Report, p. 8, accessed at http://www.budget.wv.gov/executivebudget/Documents/VIBR2015.pdf .

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  6. Chris Lawrence, Mid-Year moves allow state to finish in the black, MetroNews, July 2, 2014, accessed at http://wvmetronews.com/2014/07/02/mid-year-moves-allow-state-to-finish-in-the-black/.

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  7. West Virginia Executive Budget, Fiscal Year 2015, pp. 8-9. http://www.budget.wv.gov/executivebudget/Documents/VIBR2015.pdf .

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  8. Dave Boucher, Governor Tomblin calls for $33 Million in budget cuts, Charleston Daily Mail, January 8, 2014, accessed at http://www.budget.wv.gov/executivebudget/Documents/VIBR2015.pdf.

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  9. West Virginia Executive Budget, Fiscal Year 2015, p. 11. http://www.budget.wv.gov/executivebudget/Documents/VIBR2015.pdf .

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  10. Ted Boettner and Sean O’Leary, The Governor’s FY 2015 Budget: Doing Less With Less, West Virginia Center on Budget & Policy Issue Brief, February 2014, accessed at http://www.wvpolicy.org/wp-content/uploads/2014/02/2014-Budget-Brief-2.25.141.pdf .

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  11. Governor Tomblin line-item veto letter to The Honorable Natalie E. Tennant, March 19, 2014, accessed at http://www.budget.wv.gov/approvedbudget/Documents/govvetoletter2015.pdf.

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  12. Associated Press, “Haircut bill among those passed during special session,” March 15, 2014, accessed at http://www.timeswv.com/news/article_23109fca-2975-57e9-8b44-d624a2f3c166.html; Sean O’Leary, The Legislature Gave, and the Governor Hath Taken Away, West Virginia Center on Budget and Policy Blog, March 21, 2014 post,   accessed at   http://www.wvpolicy.org/the-legislature-gave-and-the-governor-hath-taken-away.

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  13. Dave Boucher, Tomblin Cuts $67 Million from Budget, Charleston Daily Mail, March 20, 2014 accessed at http://www.charlestondailymail.com/News/statehouse/201403200249.

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  14. Tomblin line-item veto letter. http://www.budget.wv.gov/approvedbudget/Documents/govvetoletter2015.pdf.

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  15. Kaiser Commission on Medicaid and the Uninsured, How Will the Uninsured in West Virginia Fare Under the Affordable Care Act? (Kaiser Family Foundation, January 2014.) https://www.kff.org/health-reform/fact-sheet/state-profiles-uninsured-under-aca-west-virginia/.

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  16. State Health Facts, State Decisions for Creating Health Insurance Marketplaces. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/state-decisions-for-creating-health-insurance-marketplaces/

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  17. Office of the Assistant Secretary for Planning and Evaluation, U.S. Department of Health & Human Services, Health Insurance Marketplace Premiums for 2014Databook, September 25, 2013, accessed at http://aspe.hhs.gov/health/reports/2013/MarketplacePremiums/datasheet_home.cfm .

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  18. Center for Consumer Information & Insurance Oversight, Centers for Medicare & Medicaid Services, U.S. Department of Health & Human Services, West Virginia Health Insurance Marketplace Grants Awards List, accessed at http://www.cms.gov/CCIIO/Resources/Marketplace-Grants/wv.html .

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  19. State Marketplace Profiles: West Virginia, October 24, 2013, Kaiser Family Foundation, accessed at https://www.kff.org/health-reform/state-profile/state-exchange-profiles-west-virginia/#endnote_link_89347-11 .

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  20. State Health Facts, Marketplace Enrollment as a Share of the Potential Marketplace Population. (Kaiser Family Foundation), https://www.kff.org/health-reform/state-indicator/marketplace-enrollment-as-a-share-of-the-potential-marketplace-population/.

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  21. State Health Facts, Marketplace Enrollees by Financial Assistance Status. (Kaiser Family Foundation), https://www.kff.org/other/state-indicator/marketplace-enrollees-by-financial-assistance-status/.

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  22. State Health Facts: Adult Income Eligibility Limits at Application as a Percent of the Federal Poverty Level (FPL), January 2013, Kaiser Family Foundation, accessed at https://www.kff.org/medicaid/state-indicator/income-eligibility-low-income-adults/.

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  23. Lisa Diehl, W.V. in Top Tier of Medicaid Expansion, The Daily Yonder, August 12, 2014, accessed at http://www.dailyyonder.com/print/7491.

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  24. Medicaid & CHIP: June 2014 Monthly Applications, Eligibility Determinations and Enrollment Report,

    Centers for Medicare & Medicaid Services, August 8, 2014, accessed at http://www.medicaid.gov/AffordableCareAct/Medicaid-Moving-Forward-2014/Downloads/June-2014-Enrollment-Report.pdf.

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  25. Lisa Diehl, August 12, 2014.

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  26. West Virginia Department of Health and Human Resources, Bureau for Medical Services website accessed at http://www.dhhr.wv.gov/bms/mco/Pages/default.aspx .

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  27. West Virginia response to the 2014 Medicaid Budget Survey for State Fiscal Years 2014 and 2015, Kaiser Commission on Medicaid and the Uninsured.

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  28. West Virginia Department of Health and Human Resources, Bureau for Medical Services website accessed at http://www.dhhr.wv.gov/bms/mco/Pages/default.aspx .

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  29. West Virginia Department of Health and Human Resources, Bureau for Medical Services website accessed at http://www.dhhr.wv.gov/bms/mco/pages/officeofmanagedcare.aspx .

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  30. West Virginia response to the 2014 Medicaid Budget Survey for State Fiscal Years 2014 and 2015, Kaiser Commission on Medicaid and the Uninsured.

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  31. The six counties include Wayne, Cabell, Putnam, Kanawha, Raleigh, and Mercer Counties. West Virginia Department of Health and Human Resources, Bureau for Medical Services website accessed at http://www.dhhr.wv.gov/bms/Pages/GB.aspx .

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  32. DHHR Bureau for Medical Services Announces Launch of Health Homes Initiative, West Virginia Department of Health and Human Resources, July 11, 2014, accessed at http://www.dhhr.wv.gov/News/2014/Pages/DHHR-Bureau-for-Medical-Services-Announces-Launch-of-Health-Homes-Initiative.aspx .

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  33. West Virginia response to the 2014 Medicaid Budget Survey for State Fiscal Years 2014 and 2015, Kaiser Commission on Medicaid and the Uninsured.

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