Dear Editor,
I believe that your December 25 editorial, “The Road to Fixing PEIA Goes Not Through Charleston, But Washington,” mischaracterizes the primary source of the Public Employees Insurance Agency’s (PEIA) financial struggles and unfairly suggests that the Affordable Care Act (ACA) has made healthcare inflation worse. While inflation has played a role in increasing the reimbursements that PEIA must pay to medical providers, the real issue lies in West Virginia’s decade of flat budgets, which have left the PEIA unable to cope with even the smallest of cost increases.
Healthcare inflation has undoubtedly strained public insurance programs like PEIA, but the ACA has helped mitigate this problem rather than exacerbating it. As discussed by a report from the Brookings Institute, prior to the passage of the ACA in 2010, healthcare costs rose by an alarming 69% in just five years. Since then, growth in healthcare costs has slowed significantly, with increases of 27% from 2010-2015, 22% from 2015-2020, and just 11% from 2020-2023. These trends show that the ACA has successfully bent the healthcare cost curve downward, providing relief compared to the runaway inflation of the past. Calls to repeal the ACA, as the editorial suggests, disregard this progress and fail to propose a viable alternative. Without a clear replacement that builds on the ACA’s achievements, repeal would likely destabilize the system and worsen affordability issues.
Even with healthcare inflation under better control, PEIA’s funding crisis is rooted in state-level budget decisions. A decade of flat funding, combined with reduced revenue from multiple tax cuts, has eroded PEIA’s ability to absorb costs, no matter how moderate. Unlike neighboring states, which have prioritized sustainable funding for public insurance programs, West Virginia has left PEIA underfunded. Public employees—including teachers, who are the lowest-paid in the nation—accepted lower salaries in exchange for the promise of low cost, quality health coverage. Breaking that promise because of inadequate state funding is not only unfair and unnecessary, it will only further exacerbate WV’s inability to attract an adequate number of teachers or to fill current state job vacancies.
Fixing PEIA requires state leadership to address chronic underfunding, not shifting blame to Washington or the ACA. Real solutions must focus on fulfilling the state’s obligations to its public employees by finding a sustainable, long-term funding solution.
Sincerely, John Rosato (Lost City)
