Yes, West Virginia expanded Medicaid. The state adopted the Affordable Care Act’s Medicaid expansion in 2014, extending coverage to adults earning up to 138% of the federal poverty level. Before expansion, many low-income adults without children or disabilities had no path to Medicaid coverage at all. The decision brought billions in federal funding into the state and cut the uninsured rate by more than half.
Who Qualifies Under Expansion
West Virginia’s Medicaid expansion covers adults aged 19 to 64 who don’t qualify for Medicare and whose household income falls at or below 138% of the federal poverty level. For 2025, that means a single person earning up to $21,597 per year (about $1,800 per month) qualifies. For a family of four, the cutoff is $44,367 per year, or roughly $3,697 per month.
Before expansion, childless adults were largely shut out of Medicaid regardless of how little they earned. The expansion filled that gap, making income the primary qualification rather than disability status or parental status.
How the Uninsured Rate Changed
The impact on coverage was dramatic. In 2013, the year before expansion took effect, 14.0% of West Virginians lacked health insurance. By 2022, that figure had dropped to 5.9%, a decrease of 8.1 percentage points. In a state with roughly 1.8 million residents, that shift represents tens of thousands of people gaining access to care they previously went without.
Health Outcomes in Expansion States
A study published in Health Affairs tracked low-income adults across Southern states, comparing those living in states that expanded Medicaid to those in states that did not. The results showed that expansion slowed the rate of health decline. Among people in expansion states, 36.3% experienced a drop in their health status over the study period, compared to an expected 38.1% without expansion. That 1.8 percentage point difference may sound small, but scaled up it translates to roughly 257 fewer people experiencing health decline for every 1,000 who gained coverage.
The benefits showed up in both physical and mental health. Physical health declines were reduced by 2.0 percentage points, and mental health declines by 2.1 percentage points. For a state like West Virginia, where rates of chronic disease, obesity, and substance use disorders run well above the national average, these improvements carry real weight.
What Expansion Medicaid Covers
Adults who qualify through expansion receive coverage under West Virginia’s Health Bridge Alternative Benefit Plan. This includes hospital stays, outpatient care, psychiatric treatment (both outpatient and inpatient), and rehabilitative psychiatric services. Preventive care like screenings and immunizations is covered with no cost sharing.
Dental coverage for adults 21 and older is divided into two tiers: emergency procedures for pain, infection, or fractures, and a broader set of diagnostic, preventive, and restorative services. Cosmetic dental work is not covered for adults. Children and young adults under 21 receive more comprehensive dental benefits, including orthodontics.
If someone in the expansion group has a physical, mental, or emotional condition that significantly limits daily activities, they can choose between the alternative benefit plan and the traditional Medicaid plan, which includes additional services.
Federal Funding and the State’s Share
West Virginia receives $4.5 billion in federal Medicaid funding, which accounts for 82% of total Medicaid spending in the state. That federal share is unusually high compared to wealthier states because the matching rate is calculated based on a state’s per capita income. For the expansion population specifically, the federal government covers 90% of costs, a rate set permanently after a phase-in period that started at 100% in 2014.
This funding structure means West Virginia gets back far more in federal health care dollars than it spends from its own budget. Losing expansion coverage would shift enormous costs either onto the state, onto hospitals providing uncompensated care, or onto the individuals who would lose coverage entirely.
How to Apply
You can apply for Medicaid in West Virginia through the state’s online portal called WV PATH, accessible at wvpath.wv.gov. The application asks a series of questions and then routes your information to your local county office for processing. You can save your progress and return within 30 days to finish.
If you run into technical issues with the online application, the Technical Call Center is reachable at 1-844-451-3515. You can also apply in person at your local Department of Health and Human Services office. Starting March 2, 2026, the WV PATH help desk number will change to 304-414-0047, with email support at [email protected].