West Virginia's redesigned Medicaid health insurance program is failing the state's poorest children, according to a report released Thursday.

More than 90 percent of West Virginia children with Medicaid - including newborns - have had their health benefits restricted since the program changed two years ago, the study found.

"Children are losing benefits under this punitive policy change," said Joan Alker, deputy executive director of the Georgetown University Center for Children and Families in Washington, D.C. "Clearly, the children who are most negatively impacted are children who have the most serious health care needs."

The report declared West Virginia's revamped Medicaid program "seriously flawed" and "not working as currently structured."

Alker said there's widespread confusion among families and doctors about the changes.

"This policy has been so poorly implemented that families and physicians don't understand it," Alker said. "Understanding is critical, if you're trying to change health behaviors."

State Medicaid officials refuted the report's findings Thursday, calling them a rehash of previous unwarranted criticism.

"We are terribly disappointed in Georgetown University," said Shannon Landrum, a Medicaid spokeswoman. "The information in the report is a rehash of old discussions and misconceptions. Children are receiving all medically necessary services."

Only a small percentage - about 8 percent - of parents with children on Medicaid statewide have signed "personal responsibility" agreements to improve their kids' health in exchange for expanded benefits - the cornerstone of the state's new plan.

That leaves an overwhelming majority of children with a stripped down "basic" package that has fewer benefits than traditional Medicaid.

The Georgetown study found that children comprise 85 percent of those affected by the Medicaid changes.

"Children can't sign the agreements themselves," Alker said. "If you're trying to change behaviors, why is this program targeting children?"

The basic plan limits children to four prescriptions a month. Mental health services also are restricted.

"Improving health and promoting healthy behaviors are laudable goals, but restricting health-care coverage for infants and children is not the way to achieve them," Alker said.

Why are so few parents signing up their children for enhanced benefits? Alker said the state bungled the program's implementation. 

West Virginia's redesigned Medicaid health insurance program is failing the state's poorest children, according to a report released Thursday.

More than 90 percent of West Virginia children with Medicaid - including newborns - have had their health benefits restricted since the program changed two years ago, the study found.

"Children are losing benefits under this punitive policy change," said Joan Alker, deputy executive director of the Georgetown University Center for Children and Families in Washington, D.C. "Clearly, the children who are most negatively impacted are children who have the most serious health care needs."

The report declared West Virginia's revamped Medicaid program "seriously flawed" and "not working as currently structured."

Alker said there's widespread confusion among families and doctors about the changes.

"This policy has been so poorly implemented that families and physicians don't understand it," Alker said. "Understanding is critical, if you're trying to change health behaviors."

State Medicaid officials refuted the report's findings Thursday, calling them a rehash of previous unwarranted criticism.

"We are terribly disappointed in Georgetown University," said Shannon Landrum, a Medicaid spokeswoman. "The information in the report is a rehash of old discussions and misconceptions. Children are receiving all medically necessary services."

Only a small percentage - about 8 percent - of parents with children on Medicaid statewide have signed "personal responsibility" agreements to improve their kids' health in exchange for expanded benefits - the cornerstone of the state's new plan.

That leaves an overwhelming majority of children with a stripped down "basic" package that has fewer benefits than traditional Medicaid.

The Georgetown study found that children comprise 85 percent of those affected by the Medicaid changes.

"Children can't sign the agreements themselves," Alker said. "If you're trying to change behaviors, why is this program targeting children?"

The basic plan limits children to four prescriptions a month. Mental health services also are restricted.

"Improving health and promoting healthy behaviors are laudable goals, but restricting health-care coverage for infants and children is not the way to achieve them," Alker said.

Why are so few parents signing up their children for enhanced benefits? Alker said the state bungled the program's implementation. 

For instance, Medicaid recipients receive a mailing, notifying them that they must sign up for the expanded benefit package within 90 days of the day the state determines they're eligible to renew their medical card. But the mailing doesn't state the renewal date. 

"They're never informed when the clock starts," Alker said.  

Nor does the information explain that their children are at risk of losing benefits.

"At this point, all children whose benefits have been restricted have lost them as a result of shortcomings in the system," Alker said.

Landrum said the state notified Medicaid recipients of their renewal date in a separate letter.

"No children have lost coverage," she said. "We're monitoring our enrollment data to gauge the long-term success of implementation."

Children and their parents are automatically put in the basic plan, if their parents don't sign a personal responsibility agreement.

The state's revamped Medicaid program - called "Mountain Health Choices" - was designed to entice low-income people to take steps to improve their health.

The enhanced benefit plan requires people to see a doctor, keep appointments and stay out of hospital emergency rooms. In return, they get expanded health services, such as access to cardiac rehabilitation, weight loss and smoking cessation classes.

But the program has had "no real impact" on improving health or promoting healthy behavior, according to the report. 

State officials have defended Medicaid redesign, saying the basic benefits plan offers "very good" health-care coverage. The revamped program isn't expected to be fully up and running until next year.

Medicaid provides health-care coverage to more than 230,000 West Virginia children, or about 30 percent of all kids in the state.

"This program is trying to prevent chronic diseases from developing in our young, healthy population," Landrum said. "It's far too soon to call this effort a failure."

Reach Eric Eyre at erice...@wvgazette.com or 348-4869.