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Medicaid Expansion and Tax Incentives Show Where Our Priorities Lie

On Thursday Gov. Tomblin stated that he needed more time and information before deciding whether or not the state would move along with the expansion of the state’s Medicaid program as part of the Affordable Care Act. While the health reform law calls for states to increase Medicaid eligibility to 138 percent of the federal poverty line, the Supreme Court’s recent decision has made this provision optional for states. 

Governor Tomblin states he is concerned about the cost of the expansion, despite the fact that it will cover an estimated 120,000 West Virginians without health insurance, and the federal government will cover 93 percent of the costs over 9 years. 
 
The governor is exercising a great deal of caution over a policy that we’ve known about for two years, and was made optional a month ago. And its a policy that will benefit a huge number of West Virginians. Why are we so cautious about a policy that so clearly has a major benefit, when other costly policies are fast tracked with little analysis.
 
For example, the Century Aluminum Bill, with its $20 million severance tax credit, was passed on the same day it was introduced. And state officials simply stated it would be “a wash” for the state, because of new economic activity.
 
The same is true of the cracker bill, which was passed one week after it was introduced. And despite potentially forgoing nearly $300 million in tax revenue, the bare bones fiscal note declared its fiscal impact to be $0, again, because of new economic activity.
 
Both of these example have one thing in common, they focus on subsidizing big billion dollar corporations, with little thought and question to their cost and effectiveness. 
 
Why don’t business tax incentives get the same level of scrutiny as programs that help low-income working West Virginians? It’s a rare sight to see the benefits and costs of a business tax incentive mulled over for months on end, or to have the fiscal analysis on one come out negative. Why doesn’t the state apply the same standards to the Medicaid expansion as it does to business tax incentives. We might find out, like Arkansas did, that expanding coverage results in less uncompensated care and more tax revenue on medical services, and could actually save the state hundreds of millions of dollars.
 
To compare how quickly we act on tax incentives for businesses versus expanding Medicaid, it shows where our priorities lie as a state. It is exceedingly easy and supposedly cost free to help businesses, why isn’t it the same to help our most vulnerable people?

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