Bill > HB3233

This bill creates the Affordable Medicaid Buy-in Program, a state-administered health insurance option designed to provide low-cost coverage for West Virginia residents who are ineligible for Medicaid or Medicare. The program, set to launch by January 1, 2026, will offer comprehensive health coverage including services like ambulatory care, emergency services, hospitalization, mental health treatment, prescription drugs, and preventive care. The Department of Human Services will develop the plan with a focus on affordability, establishing a sliding scale for premiums based on household income and prioritizing individuals with incomes below 200% of the federal poverty level. To fund the program, the department will seek federal financial participation through options like the Basic Health Plan Option and State Innovation Waiver under the Affordable Care Act. The plan will be administered through existing managed care organizations, use Medicaid fee schedules for provider reimbursement, and be available to all residents regardless of age, race, gender, national origin, immigration status, disability, or geographic location. Employers are prohibited from disenrolling employees who might qualify for this new insurance plan, ensuring that workers do not lose existing coverage. The bill requires the Department of Human Services to propose rules for implementation and maintain the program's sustainability while maximizing federal funding and keeping costs accessible for residents.

Health and Social Services

http://www.wvlegislature.gov/Bill_Status/Bills_history.cfm?input=3233&year=2025&sessiontype=RS&btype=bill