Republicans in Congress gutted health care funding to expand Trump’s “papers please” goon squad, and now states like West Virginia are left to absorb the fallout, forced to decide whether to slash essential services or scramble to replace billions in lost federal dollars. In this conversation, I’m joined by Mindy Renae Holcomb of West Virginia Citizen Action Group to unpack what that tradeoff looks like on the ground: who pays the price, why so-called “optional” services aren’t optional at all, and what’s still at stake as the legislative session barrels forward.This transcript has been generated with machine and human input and errors are likely. Troy Miller So we are halfway done, just about halfway done with the West Virginia legislative session, which is, for people who don’t know, a 60-day session. We are a part-time legislature here in West Virginia. And so it’s a, it’s a little bit of time to cram in a lot of chicanery and robbery and bad ideas and all of this from income tax cuts that we can’t afford to taking any sort of regulations off of private schools while cracking down and making sure the public schools have to do more with less. All of these things. If you know it is. In summary, it is impossible, I think for any single person to be able to follow everything that’s going on in the legislature. So with that as backdrop, I do find that you can follow some groups including West Virginia Citizen Action Group and which in who employ my next guest, Mindy Renae Holcomb. Mindy Renae Holcomb, who is their organizing manager, healthcare lead over at West Virginia Citizens Action Group and she joins us now. So thank you Mindy, first of all for taking the time here. Mindy Renae Holcomb Oh absolutely. Thanks for having me. Troy Miller Always a pleasure. Okay. With all of that is kind of the background about what may or may not be going on down there. What is you’re the organizing. I’m sorry, I have to get it right. Organizing manager at healthcare lead. So let’s really focus in on that angle. What, what do we have going on? What are you paying attention to? What is particularly bad or particularly good? Take it from there, if you will. Mindy Renae Holcomb Well, yeah, we’re, we’re watching for of course any vaccination adjustments that they, that may be made. You know, reduction in requirements simply because West Virginia has one of the, if not the top vaccination program in the country. It’s one of the good things we are known for and we want to keep that. We want to keep our state healthy. And so we are definitely watching that pretty closely. We’re also watching for things that we will reduce because of the HR1 is which how I simply just demand on referring to it instead of the one big beautiful bill, the big ugly bill is how I I big ugly nasty bill. Yeah. That anything that’s going to reduce any services that are associated with Medicaid, particularly because that is, you know, we have a high population in West Virginia who utilizes Medicaid. We’ve already had the disaster of the, well, this is separate from Medicaid, but the enhanced premium tax credits that got, did not get renewed and those helped lower lower middle class folks afford plans on the exchange on the marketplace. And those have pretty, that, that up in Washington, D.C. that’s pretty much been dropped. So we’ve seen a drastic reduction of folks who are utilizing the marketplace. And I think, you know, even though it’s, you know, because of everything else that’s exploded in D.C. we still need to put pressure on our representatives there to, you know, because this is such an important program and it’s vitally important to West Virginians. So I’m not ready to pull the plug on anything being done. Obviously, it’s not going to help anyone this year, but I think we need to continue to bang that drum so that we can get people back on, get people insured and get them the care that they rightfully deserve. Troy Miller Yeah. And I’ll just say on that front, I think it’s starting to become clearer in people’s actual lives what we were, you know, screaming about last year when all of this was being either inaction on the part of the enhanced tax subsidies or the enhanced subsidies or action in the terms of just gutting rural health systems. And then, you know, saying, oh, here’s, here’s what, $200 million, that whatever it is, that’s a, that’s a band aid for under the amputation after you cut billions out. And we’re seeing like, you know, local business owners here in Jefferson County. There are a number of them who I know have said my family could no longer afford the, the coverage we need. And we’re going to piece it. Well, you know, we’ll try to piece it together, but please call your Congress, your Congress critters here in West Virginia. Yeah, that is huge. And to really hammer it home, West Virginia is also one of the states with the highest rates of people living with disabilities. And so there’s this whole article or feature over at PBS NewsHour a couple of weeks ago, particularly about how people with disabilities are going to bear the burden of these Medicaid funding cuts more than other people with disabilities in rural areas are going to disproportionately impact it. And it really pissed me off when I saw a couple of it must have been last month that our Congress people didn’t even manage to get us like the per person, per-rural-patient the same amount of revenue or the same amount of incoming funds to make up the Medicaid cap as, like, rural New York or rural Connecticut. Which just boggles my mind that we have such bad negotiators in Congress who are willing to just. I mean, with Shelley, her son got an appointment to the federal prosecutor’s office or the representing this dish. So, you know, cool, I guess, for them, but for the rest of us in West Virginia. Yeah. And it’s up to the. It’s up to our state legislature now to either exacerbate this problem through inaction or to start to address the problem from the state level. What are you looking at in terms of that? I know that there are some. There have been some movement that might even have some bipartisan support to, like, not totally hose all of us, but correct me if I’m wrong. Mindy Renae Holcomb Well, what we are concerned about is that Morrissey has said, don’t ask for any state funds to supplement or not supplement, but replace federal funds. So that’s going to put us in a pretty hard, hard way. And also, one of the ways that they are going to have. That they’re going to have to look at this is by cutting optional services. And that would be dental care that we fought so hard to get for West Virginia. I’m really worried about how IDD waiver is going to survive this. That is considered an optional service. So for those that don’t, there are services that are absolutely required under federal mandate for Medicaid. Anything else that is provided through the states is considered optional, and they aren’t what we would consider optional. Troy Miller Right, right. And I just want to ask you to elaborate on IDD a little bit. Mindy Renae Holcomb What is it for sure, Intellectual, developmental disabilities. So folks that have, you know, autism, that need additional care, those who have other, you know, disabilities that affect their ability to work, go to school, that need extra services in order to allow them to live a full life and participate fully in school and in work. Those services can be cut, eliminated. I mean, I’m not trying to put the fear out there, but it’s just. Troy Miller It could be right, something, as you were about to say, they’re not optional for the families, you know. Mindy Renae Holcomb Exactly. Troy Miller These services need to be. Especially, I mean, with dental, it really puts the nail on the head. Like, I’m sorry, we all have teeth. You know, it’s not really an optional thing to take care of them or not. And they’re a big indicator for our general health. Mindy Renae Holcomb 100%. Troy Miller And it’s only because the dentistry lobby has been so effective in America of sectioning themselves off from the rest of healthcare that this is even a discussion. Which is why, right. We don’t have any sort of. Well, we don’t have any universal healthcare, but there’s not even a requirement for dental services on private insurance to cover any damn thing. Basically, it’s all very patchwork, which is why we see commercials on the TV for this type of dental insurance and this type of supplemental dental insurance and all of this. Which is just mind boggling in the richest country in the world at the richest time in our history that we’ve turned an industry into. Hey, do you have teeth? Do you not want them to fall out of your head? Great. You can pay for this extra insurance for it. You know, that’s absurd. And our governor has, of course, he’s not going to supplement the funds with what we actually need. And as I pointed out back then and in past years, these are federally matched funds a lot of the time. So it’s not just, you know, we’re not just cutting the spending by $1, we’re cutting it by $2 to $3 a lot of the time. Just right out of our system and right out of the care that, yeah, West Virginians need just as much as anyone. What else do we have going on down in the legislature? Watch on YouTube, Like and Subscribe! Mindy Renae Holcomb Well, you know, I would argue more. So we have a very aging population. We have a very sick population. So, you know, I would put the argument out there that, you know, I have said from the beginning of HR1 that West Virginia will suffer the most out of anyone in the nation. And I still stand by that statement. And we seem to have a lot of folks who, you know, in our legislature who are prioritizing other pet projects or, you know, I’m just going to name it. And this is me speaking as M
