West Virginia axed its Mountain Health Choices program in September 2010 after the federal healthcare law prohibited states from forcing Medicaid recipients into plans with stripped-down benefits. Under the plan, Medicaid recipients could choose from either an enhanced plan, which offered more health services, such as weight loss programs, or a basic plan. Under the enhanced option, recipients could use EDs only for emergencies under a “member responsibility agreement.”
The basic plan offered limited prescriptions and other health services, but it had no restrictions on ED use. Medicaid recipients were automatically enrolled in the basic plan unless they signed up for the enhanced plan.
In West Virginia, only 14 percent of Medicaid enrollees chose the enhanced plan between 2007 and 2010. Medicaid recipients who signed up for the enhanced plan reduced their number of ED visits by about 5 percent, according to the report.
Overall, however, the number of ED visits grew because the majority of West Virginia Medicaid recipients were still on the basic plan. The restricted services under that plan had “unintended consequences” of increased ED visits, according to the report.
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