W.Va. tops in Medicaid expansion enrollment

BUCKHANNON – Per capita, West Virginia has the highest number of people registered for the Patient Protection and Affordable Care Act’s Medicaid expansion program in the nation, according to state officials.

The act, also known as Obamacare, gave states the option of expanding their Medicaid program to include people who were not previously eligible for coverage, and in 2013, West Virginia chose to expand Medicaid coverage.

Registration opened on Oct. 1, 2013, and as of Monday, Dec. 23, nearly 83,000 people had been deemed eligible for Medicaid under the expansion, West Virginia Department of Health and Human Resources Secretary Jeremiah Samples said Friday.

“As of Monday, 82,981 folks had gone through the process and have been determined eligible,” Sample said. “West Virginia, per capita, has the highest number of people signed up for the Medicaid expansion.

“Certainly, there are other states that have registered more people numerically, but when you look at population, we’re way ahead, and that’s because we undertook several strategies to, in essence, prequalify people (for coverage under the Medicaid expansion).”

Samples said the DHHR utilized an autoenrollment process through which it identified consumers who had signed up for Medicaid and were not previously eligible; consumers who had registered their children for the West Virginia Children’s Health Insurance Program, or CHIP; and consumers who have qualified for food stamps through the Supplemental Nutrition Assistance Program, or SNAP.

“Based on those qualifiers we were able to identify about 118,000 consumers that could be eligible for the expansion, and basically we sent out letters, and they just had to check mark a box and sign their name and send it back to the DHHR office,” Samples said. “Through that process alone, we had 71,000 people go through the enrollment process.”

West Virginia was one of only four states to implement the autoenrollment strategy, Samples added.

To qualify for Medicaid under the Affordable Care Act expansion, a person’s household income must be 138 percent of the poverty level or below. According to a DHHR informational brochure, that amount is $15,856 for a household of one; $21,403 for a household of two; $26,951 for a household of three; and $32,499 for a household of four.

Samples said that although the DHHR has reached a large chunk of eligible consumers, there are still individuals who haven’t gotten the message that they may now be eligible for Medicaid.

“We certainly hope people are getting the message, but you’re never going to reach 100 percent of the population,” Samples said. “We had an actuarial study done that estimated that there are actually 130,000 people eligible for the expansion.

“In my opinion, the federal government has not done an adequate job of getting information out to consumers in an accurate way,” he said, “so if people have questions and concerns, especially about the Medicaid piece, we encourage them to call our office, go into their county DHHR office and we have a lot of resources online.”

Help for individuals who want to shop for insurance in the private marketplace is also available at DHHR offices. Samples said the DHHR has developed a memorandum of understanding with the West Virginia Offices of the Insurance Commissioner that provides federal funding for in-person assisters, or IPAs, to be stationed at every DHHR office in the state.

Those individuals are charged helping people sign up for insurance plans that may be purchased in the private marketplace; Highmark Blue Cross Blue Shield West Virginia is the only insurance provider offering plans through the marketplace.

For more information about signing up in the private marketplace or for health coverage under the Medicaid expansion, visit, call 1-800-318-2596 or visit your local DHHR office.

In addition to the DHHR, other agencies have in-person assisters to help individuals apply for health insurance coverage, and a list of those organizations can be found at

Coverage through both insurers in the private marketplace and via the Medicaid expansion program begins Jan. 1.