Thousands of West Virginians breathed a sigh of relief when Gov. Earl Ray Tomblin announced a long-awaited decision to expand Medicaid coverage for low-income workers under the Affordable Care Act. According to Gov. Tomblin, “We anticipate expansion will allow us to provide insurance coverage to approximately 91,500 working West Virginians, significantly reducing the number of uninsured.” Some estimates of the number of people covered are much higher.

Medicaid expansion for adults earning up to 138 percent of the poverty level was originally mandatory for states. However, when the U.S. Supreme Court ruled on the constitutionality of the law last year, it made expansion a state option. To date, 22 other states have opted in.

West Virginia’s senior U.S. Sen. Jay Rockefeller, a longtime health care champion, told those who gathered for the May 2 announcement that “One out of every four West Virginians—not strangers, but the men, women, and children we know from the playground, church, or the grocery store—still do not have health insurance… today I am so proud to stand with him to announce this enormous step forward.”

AFSC’s West Virginia Economic Justice Project was one of many groups that pushed for this expansion. According to project director Rick Wilson, “This is the biggest advance for social and economic justice in my lifetime. These are people who wait on us in stores and restaurants, take care of our children and our elderly and do all the grunt work that keeps this state on the rails.”

Health care has long been a focus of AFSC’s work in West Virginia. The project supported the creation of the state’s Children’s Health Insurance Program in 1998 and its expansion over the years. It supported passage of the Affordable Care Act and related legislation as well as improvements in the state’s traditional Medicaid program.

AFSC worked with several religious, labor, and advocacy organizations on this issue. It was the top item on the platform of Our Children, Our Future, a campaign opposing child poverty, in which AFSC was very active. The coalition sponsored a Kids and Families Day at the state legislature which over 450 people attended and held regional forums throughout the state. AFSC staff spoke at public forums, published op-eds, met with state officials, and worked to mobilize supporters of the expansion to contact the governor’s office.

One unique AFSC contribution was to bring the voices of those impacted by the decision to the debate. According to project coordinator Beth Spence, “We asked what we could do, and the directors of West Virginians for Affordable Health Care asked if we could tell the stories. The Cabin Creek Health Clinic, a great coalfield health provider, helped us locate people willing to talk about Medicaid expansion. They opened their doors so we could hear about the challenges they face. We were fortunate to locate Celena and Heather and Bill and Teressa, who bravely shared their stories.”

The result was a booklet titled The Case for Medicaid Expansion, which was released at a Medicaid forum in Charleston on April 7. Copies were given to Gov. Tomblin and his staff, state legislators, public officials, and allies.

Celena Roby was one of the people profiled. A survivor of domestic violence who still suffers from its effects, Celena also attended the day of action at the Capitol and spoke eloquently with Gov. Tomblin’s staff. She was there to celebrate the victory when the expansion was announced. Celena told her experiences to the Associated Press, saying “A lot of the time, the reasons that people stay in domestic violence situations are economic. You add health care to that, and that makes it an even greater burden…This would allow me to take care of myself, making it easier for me to take care of my children.”

Rob Alsop, Gov. Tomblin’s chief of staff, told the media that the decision was neither fast nor easy. One factor was the outcome of an actuarial audit that favored the expansion. However, the Associated Press notes that “in the months leading up to Tomblin’s decision, Alsop fielded weekly inquiries and appeals from advocacy groups and organizations representing health care providers on the topic. These representatives appeared uniformly in favor of expansion…”

Speaking for AFSC, Beth says, “We were proud to be part of a large collective effort that will help a lot of people.”