West Virginia is one of the poorest and sickest states in the nation.
Close to 20 percent of West Virginias, or 332,000 individuals, live below the federal poverty level while another 20 percent, or 360,000, live between 100 and 199 percent of the federal poverty level. Particularly affected are children, close to 30 percent of whom live below the poverty level.
Inherently related to the poverty experienced by West Virginians are poor levels of overall health. Indeed, the state scores worse than the national average on virtually every health-related category and usually falls into the bottom decile. Indeed, on an overall health index created by the Social Science Research Council, West Virginia scores second lowest in the nation
West Virginians are also extremely affected by addiction problems. About 70,000 West Virginians are suffering from alcohol dependence or abuse. Opioid overdose death rate in West Virginia stands at 43.4 compared to 13.3 nationwide. The overall drug overdose death rate is 52.0 compared to 19.8 nationwide.
The combinations of rampant poverty and disabling conditions have made West Virginia into a state with the highest share of its population enrolled in Medicaid. Indeed, 564,000 individuals are covered by the program. The Medicaid and the Children’s Health Insurance Program (CHIP) are crucial for state’s children, covering about half of them.
Since its passage in 2010, the Affordable Care Act has also done much to improve the lives of West Virginians. For one, it expanded coverage to hundreds of thousands of individuals through Medicaid and the insurance marketplace. It also added valuable protections for those on private coverage by forcing insurers to cover pre-existing conditions, banning annual and life-time coverage limits, and requiring insurance companies to cover a minimum level of benefits termed Essential Health Benefits.
Both the Affordable Care Act and Medicaid are crucial for the health of West Virginians and the state and its health care system. Yet both are likely to be subjected to high-profile lawsuits in the near future. Lawsuits in which the vote of Brett Kavanaugh may be crucial.
Litigation challenging all or parts of the ACA continue to meander through the courts more than eight years after its passage. The Supreme Court will likely play a decisive role by voting on many of these, with the potential to undo part or all of the Affordable Care Act. These range from challenges to contraception coverage and litigation that seeks to end protection for preexisting conditions, to global challenges (such as one currently in pending in district court in Texas) that seeks to undo the entire law.
As for Medicaid, it seems likely that work requirements, with potential to eliminate coverage for millions of Americans, are going to undergo continued litigation.
These lawsuits are particularly crucial because they come at a time when the nation’s safety net finds itself under massive attack. Congressional Republicans have been open about their favored agenda:
— Cuts to Medicaid and block granting the program.
— Undoing the Medicaid expansion.
— Cuts to the Children’s Health Insurance Program.
— Eliminating the Affordable Care Act with its protections for preexisting conditions.
— Cutting food stamps.
— Privatizing Medicare and Social Security.
No matter where you stand on these issues, West Virginians, more than residents of any other state, have a major stake in these decisions, many of which will end up before the Supreme Court. And we deserve to know what a potential Supreme Court Justice Kavanaugh thinks about these issues.
I encourage both of the state’s senators, Senator Shelley Moore Capito and Senator Joe Manchin, to take their “advice and consent” role seriously by listening to their constituents, whether they like what they have to say or not, and by asking tough public questions of the President’s nominee.
The health of the state of West Virginia is at risk.