On April 17, 2006, West Virginia enacted legislation (HB 4021) which aims to address issues related to health care costs and access. The legislation includes four major initiatives:
§ Coverage expansion for children: HB 4021 increases eligibility for children in the State Children’s Health Insurance Program (SCHIP) from 200 percent to 300 percent of the federal poverty level (FPL). Estimates indicate that an additional 4,300 children will become eligible as a result of this expansion. Children in families in the new expansion group will be required to pay monthly premiums, deductibles, coinsurance and/or co-payments.
§ Clinic-based preventive care pilot program: This measure allows for the establishment of a pilot project that will allow up to eight clinics or private physician offices around the state to sell prepaid primary and preventative care to uninsured individuals or businesses that currently do not provide health insurance to their employees. No coverage for specialist or hospital services is provided under this program. The program would be overseen by the West Virginia Health Care Authority and sunsets after three years.
§ Minimum benefit plans sold in the state: This measure allows the insurance industry to sell limited benefit health plans in the non-group (individual) market that are focused on primary and preventative services, with limited access to specialist or hospital care. Only individuals who have been uninsured for 12 months will be qualified for this product.
§ Interagency Health Council: HB 4021 calls for the establishment of an interagency council to study future health care reform. Members of the council would include Directors from the five major state agencies that work on health care issues. The council will be responsible for establishing critical benchmarks for the state related to access, cost containment, quality, and financing.
