Date Requested: February 10, 2021
Time Requested: 04:48 PM
Agency: Health and Human Resources, WV Department of
CBD Number: Version: Bill Number: Resolution Number:
1486 Introduced HB2241
CBD Subject:



Sources of Revenue:

Other Fund General & Federal

Legislation creates:

Creates New Fund:

Fiscal Note Summary

Effect this measure will have on costs and revenues of state government.

The purpose of this bill is to create the Affordable Medicaid Buy-In Program. The bill requires the Department of Health and Human Resources to develop and administer the Affordable Medicaid Buy-In Plan. The bill creates the Health Care Affordability And Access Improvement Fund. The bill establishes an advisory council to the Affordable Medicaid Buy-In Program. The bill requires a study and reposts be made. The bill defines terms. The bill sets limitations of employers. The bill requires rule-making. The bill appropriates $12 million to the Health Care Affordability and Access Improvement Fund, and $12 million to the Department of Health and Human Resources. The Department allocates $6,325,640 annually for Indigent Care services at the states 13 Comprehensive Behavioral Health Centers. The Indigent Care program covers individuals up to 200% of the FPL who are not covered by Medicaid or another insurer. With the implementation of this bill, it would be expected that a portion of the individuals who may currently be receiving Indigent Care Services would switch over to the Medicaid buy-in program. An estimate of the potential cost savings to the Department cannot be determined at this time (without further analysis of the expected number of individuals who will opt in). Without further research, the cost could exceed the $12 million allotted in the proposed legislation. See explanation below. Revenue would begin in FY2023 for members who have maintained a job and have not relapsed. Revenue would be established to cover the costs of their substance abuse services and will be determined by an actuary.

Fiscal Note Detail

Effect of Proposal Fiscal Year
Fiscal Year
(Upon Full
1. Estmated Total Cost 0 12,000,000 12,000,000
Personal Services 0 0 0
Current Expenses 0 12,000,000 12,000,000
Repairs and Alterations 0 0 0
Assets 0 0 0
Other 0 0 0
2. Estimated Total Revenues 0 0 0

Explanation of above estimates (including long-range effect):

According to 2019 survey from the Kaiser Family Foundation, 142,598 (8.2% of the WV’s population) are uninsured. “West Virginia experienced a statistically significant change (0.6%) from the respective year to 2019 at the p>0.05 level. Includes nonelderly individuals ages 0-64.” The uninsured population in WV increased by approximately 7,100 individuals. As written, DHHR would be the entity that collects premiums from enrollees and taking on the responsibility of the claim risk. Members, as defined by the proposed legislation, would not be eligible for federal financial participation. Costs to design and implement a state insured plan requires expertise that is not readily available, including actuarial support, consultants, and data analysis. Therefore, without further research, the cost could exceed the $12 million allotted in the proposed legislation. It assumed that funds would not be reverted back to the general revenue fund, as stated in §9-4F-5 (a) and §9-4F-10 (b). However, §9-4F-10 (a) contradicts other lines in the proposed legislation stating that, "Any unexpended or unencumbered balance remaining at the end of a fiscal 2022 shall revert to the general revenue fund."


    Person submitting Fiscal Note: Bill J. Crouch
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