FISCAL NOTE

Date Requested: January 30, 2018
Time Requested: 02:14 PM
Agency: Health and Human Resources, WV Department of
CBD Number: Version: Bill Number: Resolution Number:
2267 Introduced SB417
CBD Subject: Human Services


FUND(S):

0403 - DIV OF HUMAN SERVICES GENERAL ADMINISTRATION FUND

Sources of Revenue:

General Fund

Legislation creates:





Fiscal Note Summary


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


    The purpose of this bill is to amend the definition of medical services to exclude abortion.
    The Department does not have specific detail available to determine if current expenditures would meet the revised definition, therefore, the fiscal impact of this bill could result in a decrease in state expenditures of $350,000 to $400,000. This estimate is based on the current pregnancy termination expenditures covered by the Department.
    Additional costs to the Department could be incurred dependent upon the number of live births that would occur, based on the changes in this legislation.
    



Fiscal Note Detail


Effect of Proposal Fiscal Year
2018
Increase/Decrease
(use"-")
2019
Increase/Decrease
(use"-")
Fiscal Year
(Upon Full
Implementation)
1. Estmated Total Cost 0 0 0
Personal Services 0 0 0
Current Expenses 0 0 0
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):


    Please explain increases and decreases in personal services, current expenses, repairs and alterations, assets, other costs and revenues, including assumptions and data sources and delineation between start-up and ongoing costs. Please also include a long-range schedule of costs and revenues if fiscal impact is expected to vary in future years.



Memorandum


    There could be additional cost to the Medicaid program if this legislation impacted whether or not the procedure occurred. The cost represents annual cost for a child on Medicaid. There were 1,560 abortions in 2017. Using 1,560 * $530 (average PMPM TANF capitation for <1 y/o) * 12 = $9,921,600. Of this amount, $2.5M would represent the state portion. Therefore, cost could be $0-$2.5M state funds, depending on if Medicaid's inability to fund was a consideration as to whether the procedure occurred.
    The term "essential" is a term which can be read in different ways. For example, it could be interpreted to mean the Department cannot provide certain services that are not mandated by federal law to be included in Medicaid, but instead optional in Medicaid. Some examples would be all waiver services (all waiver services are optional), pharmacy, personal care services, and physical therapy. In turn, this could cause problems with the Departments' authority to expend state dollars (and draw down federal dollars) for these services. For example, since most of the expenditures in Medicaid come from the Medical Services Fund in 9-4-2, if the "essential" qualifier were placed into the definition, it would limit expenditures to "essential" medical services, and therefore potentially eliminate the optional services.
    



    Person submitting Fiscal Note: Bill J. Crouch
    Email Address: dhhrbudgetoffice@wv.gov