Medicaid waiver a tricky choice for legislators

Hundreds, perhaps thousands, of opportunities exist within West Virginia’s state budget for legislators to disagree with one another and Gov. Earl Ray Tomblin. One line item ought to be beyond argument, though in past years there has been some controversy over it.

State officials have some latitude in how the Medicaid program is handled, though most of the cost is paid for with federal money. That can result in disputes over what types of health care should be paid for by Medicaid.

One program is the so-called Medicaid waiver. It can provide low-income and disabled West Virginians with help paying for the cost of care they receive in their own residences instead of in nursing homes.

For a few years, state officials tended to hold down spending on the Medicaid waiver program. As we noted some time ago, that was a penny-wise but pound-foolish approach.

Some Medicaid-eligible West Virginians need care, perhaps only with normal living tasks, that can be provided in their homes. If they cannot get it there, through home health aides or similar options, they may have no choice but to go to nursing homes. If Medicaid has to pay, that can cost the state more than if home care options were covered.

In many situations, then, providing more slots for the Medicaid waiver program can save the state money.

Both the House of Delegates and state Senate already have adopted versions of the $4.1 billion general fund budget for the coming fiscal year. Senators went along with Tomblin’s recommendation of $11.9 million for the Medicaid waiver program – but the House approved $14 million.

Again, it is entirely possible appropriating the higher amount may save the state money in the long run. Unless they have some reason to believe otherwise, senators should revise their budget proposal to agree with the $14 million in the measure already passed by the House.