Creating the Affordable Medicaid Buy-In Program

HB 4821 creates a new state-run health insurance program in West Virginia that allows eligible residents to "buy in" to a Medicaid-like plan. It directly affects adults who are ineligible for Medicaid or Medicare but remain enrolled in employer-sponsored coverage (and whose employers haven’t denied them coverage due to this program). The plan uses a sliding-scale premium based on income, covers essential services like hospital care, mental health, prescriptions, and preventive care, and must coordinate with existing Medicaid to avoid coverage gaps. The West Virginia Department of Human Services will administer the program, prioritizing those transitioning from Medicaid, and must apply for federal funding to maximize cost efficiency.