“I’ve never been sober a day or two since I was 16,” Omps, who was 34, texted her sister on Oct. 5 of last year. “I do not want to be addicted. I fucking hate needing something to feel normal. I might as well actually get high if I’m going to be an addict.”

Though she resented the suboxone, people close to her said it was crucial to her recovery from substance use disorder. And so it was catastrophic that she could no longer obtain it, midway through 2023, after she was kicked off Medicaid. 

At the onset of COVID-19, the federal government suspended normal rules for Medicaid to keep people from losing coverage during the pandemic, allowing recipients, including Omps, to go three years without having to demonstrate eligibility. But that policy ended in March 2023, and Omps and millions of others across the country were swiftly dropped from government coverage—for instance because they forgot to file for renewal or made a mistake on their paperwork, or because they had moved to a new state or started earning too much money to qualify for Medicaid. In West Virginia, this change was compounded by the existing staffing and funding challenges in the state’s Medicaid office, and the legislature’s inaction to avert this cliff.

In 2022, Omps started working at the nonprofit West Virginia Family of Convicted People, where she organized events to protest and raise awareness about conditions inside West Virginia’s deadly jails. The job paid $22 an hour, which put her in a difficult spot: She was making too much money to stay on Medicaid, but the job didn’t provide health insurance and Omps didn’t couldn’t afford to pay out-of-pocket for her drug treatment.

“She had to go off of suboxone and that is what put her body under a lot of stress,” Omps’ sister, Victoria Omps, told Bolts recently. “It was so hard on her, because of how expensive it was going to be to stay on.”

Already in withdrawal from hard drugs, Omps suddenly found herself in withdrawal from the medication that was treating her addiction. On Oct. 18, she entered the steam room of a YMCA in Charleston, West Virginia’s capital city, then collapsed and died as she got up to leave. She was 34 years old, and though she officially died of a heart attack, Victoria and others who knew Ashley told Bolts they have no doubt about what killed her.

“I think it was entirely about her having to come off of suboxone,” Victoria said. “The withdrawal was so hard. That was the reason she was even in the steam room, so she could try to sweat it out of her pores.”

The so-called unwinding of Medicaid coverage has, as of late last month, led to the disenrollment of more than 17 million Americans, according to a Kaiser Family Foundation analysis. West Virginia has been hit particularly hard: It is one of the poorest states in the country, and thus has one of the highest rates of Medicaid enrollment. The return to normal Medicaid rules has led to the removal of nearly a quarter of all West Virginians who’d been enrolled as of last spring, the Kaiser analysis shows.

Those who work in drug treatment and addiction recovery in West Virginia say this drop-off in coverage has endangered people with substance use disorder and compounded a larger crisis in a state that has already led the country in overdose death rate every recorded year since at least 2014, according to federal data. 

As patients like Omps lost access to addiction treatment, advocates pressed state leaders to expand Medicaid eligibility and treatment options in the state. Instead, even in the face of this crisis for drug treatment and recovery, many West Virginia lawmakers have turned to a different approach, pursuing new punishments for people addicted to illegal drugs in a state that already incarcerates more people for drug possession than for almost any other charge. 

The state legislature, which is controlled by Republican supermajorities, already restricted syringe exchange programs in 2021; this year, it considered bills to outlaw syringe exchanges entirely, as well as to ban methadone—a medication that treats opioid addiction, as suboxone does—and the distribution of clean drug supplies. West Virginia lawmakers also have repeatedly advanced legislation to turn simple drug possession from a misdemeanor to a felony offense punishable by up to five years in prison. 

“We’re trying to be proactive here,” Republican state Senator Vince Deeds, the sponsor of that proposal, told Mountain State Spotlight in January. “Right now, if you have someone go in for simple possession, they’re back out and they’re committing more crimes to feed their habits. The idea here is to have early intervention with these end-level users.” (Deeds did not respond to multiple requests for comment from Bolts.)

Deeds’ bill passed the state Senate both in 2023 and this January, but it stalled in a House committee last week as lawmakers declined to pass it. Instead, House Republicans decided to study higher penalties for drug possession in the future, which would push this focus on increased penalties into coming years. 

Many who advocate for those struggling with addiction in West Virginia feel frustrated seeing lawmakers focus during their limited time—the 2024 session is already set to end this week—on such solutions. These advocates argue that treatment offers more public safety benefits than harsher punishment, a position bolstered by years of research showing that incarceration does not deter drug use. 

“Instead of putting the money and funds into increasing access to treatment, increasing resources and funding to organizations helping with drug treatment, they’re talking about throwing good money after bad by increasing penalties and increasing incarceration rates,” said Kenneth Matthews, a recovery coach who is himself in long-term recovery from addiction. 

“There’s not enough money put into treatment facilities,” he said. “Never in the history of people committing crimes has anybody in the midst of their substance use said, ‘Oh, they just increased the penalty, so I’m not going to do this.’ As someone who was formerly incarcerated and in long-term recovery, when I was in the midst of substance use I wasn’t following the legislature and I really didn’t care.”

David Foley, the chief public defender in Mingo County, a rural area in the southern part of West Virginia that The Guardian once called “the opioid capital of America,” said he sees a host of other criminal charges that seem to stem from untreated addiction. “I see so many crimes where, if they are not drug offenses, they are fueled by the desire to get money to get drugs, or it’s people so down on their luck because of drugs,” Foley said. “It just seems like the entire spectrum of criminal charges are in some way influenced by substance abuse.”

Mingo County Sheriff Joe Smith, a Republican, confessed that he sometimes wonders whether arrests and incarceration for certain drug charges are doing any good for people suffering addiction. Smith told Bolts that he and his deputies often arrest the same people over and over again for the same drug-related crimes, and added that even if he could arrest every single person who sells drugs in the area, he doesn’t think Mingo County could solve its problems related to addiction through enforcement alone.

“Out of every crime we work, 80 percent is drug-related. We’ll arrest someone who stole grandma’s earrings, but when you get to the root of it, it was to sell the earrings for a hit of meth or some fentanyl,” Smith said. “It’s a sad situation. I’ve arrested people, and arrested their kids, and worked overdoses off people who I’ve begged to get help.”

Overdose deaths are a regular occurance in Mingo County, which has a population of just over 20,000. Rebecca Hooker, who runs a social services organization in the county, told Bolts that, recently, on a single day in a single 10-mile radius, her community saw four people die of suspected overdoses. “The people in the sector of harm reduction or prevention or rehabilitation really need more money,” Hooker said. “Right now it’s just catch and release.”

Matthews said his work as a recovery coach is particularly difficult these days, now that he must contend with the fact that many of his clients, who are already at high risk of incarceration or overdose—or both—are also trying to navigate the ongoing Medicaid mess. He talked about one client who had to leave a treatment facility because they lost Medicaid coverage, then spent months re-establishing eligibility, only to find that the treatment facility had no bed space for him to return.

“I was worried he’d have a fatal overdose,” Matthews said. “People lost their health care and had to leave their residential programs because they no longer had the ability to pay for it through Medicaid. Some of them were able to hold on and some were not.” 

West Virginia’s state Medicaid office has faced criticism for not doing enough to help people keep coverage after the rules changed. In a letter last summer, the federal Centers for Medicare and Medicaid Services admonished the state for keeping people on hold for long periods of time when they called in for help, and warned that this and other forms of administrative dysfunction would lead to many eligible people losing coverage. 

Rhonda Rogombe, health and safety net analyst for the West Virginia Center on Budget and Policy, said administrative hurdles have been a particular problem for people needing treatment for substance use disorder. “This is a very vulnerable group of people,” she told Bolts, “and they’re being disconnected from programs they were enrolled in, or could be eligible for.”

Deborah Ujevich, who works at a detox facility outside Charleston, and was close with Ashley Omps, says people have been scrambling over the past year to find addiction treatment after losing Medicaid coverage. “People would call us for a bed and you look their Medicaid up with the system, you go look at member eligibility, and you see no enrollment found,” Ujevich said. “So you can’t take them, and they can’t get meds because the pharmacy isn’t going to fill their protocol.”

Omps’ death while searching for treatment was sadly not unique, Ujevich said, adding, “We have had a number of past patients die because they aren’t getting the care that they need.”

She finds it frustrating that the state continues to pursue harsh enforcement despite little evidence that incarceration is helping to stem substance abuse, especially after so many lost access to addiction treatment under Medicaid.

“They are doubling down here on bad policy and they are not taking into consideration what is actually happening. It’s very, very, very out of touch,” Ujevich said. “We’re really going backward.”

The post Drug Treatment Crisis Grows in West Virginia, But State Just Looks Toward More Punishment appeared first on Bolts.

Workman sat on West Virginia’s supreme court in 2018—one of the three Democratic justices in the court’s majority—when Republican lawmakers decided to impeach that entire court. The GOP had flipped the legislature in 2014 for the first time in decades, and it had seized the governorship in 2017; only the supreme court stood in the way of one-party rule in the state. 

“All of a sudden, we had this right-wing legislature wanting to impeach everybody,” she recalls, “and they wanted in my opinion to get rid of us so they could put their own.”

When Workman read this summer that Protasiewicz may be impeached, shortly after her victory flipped Wisconsin’s high court to the left, she was struck by the parallels with what she herself went through. “The Wisconsin situation is a complete power grab to undermine democracy,” she told Bolts. “It shocks me because it even goes further than the one that I experienced.” 

She added, “It’s this whole thing that’s scary going on in this country, that if you can’t defeat people’s votes then you do it in some other way.” 

Protasiewicz won Wisconsin’s supreme court election in April, giving liberals a 4-3 majority on the court, their first in 15 years. But Republicans began to float impeaching Protasiewicz before the results were even known. The party has already locked down control of the legislature, using aggressive gerrymanders to protect itself from election defeats. It has also deflated the powers of the Democratic governor, Tony Evers, undercutting his authority to appoint people to executive branch positions. 

But by electing Protasiewicz, voters threatened the GOP’s hold on power by opening the door to an anti-gerrymandering ruling by the court. Just days after Protasiewicz was sworn-in, voting rights groups filed two lawsuits asking for the state’s legislative maps to be struck down as unconstitutional gerrymanders. 

Speaker Robin Vos, former Governor Scott Walker, and other Republicans have demanded that Protasiewicz recuse herself from these cases or else risk impeachment. They say comments she made while running—she notably called the state’s current legislative maps “rigged”—mean that she has “prejudged” the cases. Candidates in Wisconsin routinely share views on issues or are attached to political parties, though, and the Wisconsin Judicial Commission dismissed complaints filed by the GOP that her statements violated ethics rules.

Vos, who leads the Assembly, where impeachment proceedings would start, is still pushing forward this month. Thanks to the large majorities the state’s gerrymandered maps have delivered the GOP, his party currently holds enough seats to impeach Protasiewicz in the Assembly and then convict her in the Senate if all Republican lawmakers hold together.

Removing Protasiewicz would go far beyond the legal guardrails for impeachment laid out in the state constitution. Legal experts in Wisconsin say a plain reading of the document undermines the Republicans’ case against Protasiewicz.

But these legal barriers may not constrain the GOP. Constitutional protections are only as strong as the will to enforce them. Republican lawmakers may try to blow past them even if there is little legal justification, because at that point it’s uncertain at best who or what could stop them. 

Most notably, the allegations against Protasiewicz do not seem to fit the circumstances under which Article VII of the state constitution contemplates impeachment: It reserves it for “corrupt conduct in office, or for crimes and misdemeanors.” Protasiewicz is not accused of criminal conduct, she has yet to do much of anything “in office,” and she faces no allegations of bribery or personal gain, which is traditionally how corruption was defined. 

“It’s a difficult fit with the historical understanding of corrupt conduct in office,” says Chad Oldfather, a professor at Marquette University Law School. “You are talking about a justice being impeached before even hearing or deciding a case,” says Doug Keith, senior counsel in the Brennan Center’s Judiciary Program, a national program that tracks state courts. “This is not how impeachment has been used, or how I would expect it to be used.” 

In fact, Wisconsin has a separate procedure, known as “removal by address,” allowing lawmakers to remove judges for “misconduct”—a broad category that would better fit the GOP’s charges against Protasiewicz. Republicans lack the votes for the far higher threshold that this procedure requires in the Assembly (two-thirds, rather than a simple majority).

But Keith added that this may not matter in practice to how this confrontation unfolds, saying, “it’s a separate question of what would happen if the legislature followed through on this.” 

Miriam Seifter, a professor at the University of Wisconsin-Madison Law School, also says she does not think that the allegations against Protasiewicz meet the constitutional standards of impeachment, but she too warns that lawmakers may decide they don’t care, betting that no one will check them.

“That is one of the precarious aspects of this situation,” says Seifter, “once one legal actor does not adhere to the constitution, it’s hard to predict the rest of the legal trajectory.”

A lawsuit would likely follow Protasiewicz’s impeachment, but it’s unclear whether any judge would agree to even consider if the charges against her fit the circumstances laid out in Article VII. Courts have typically deferred to lawmakers on impeachment, treating it as a “political question” that is not subject to judicial review, Oldfather and several other legal experts told Bolts. Still, Oldfather also said there is no telling how that question would go in Wisconsin because there’s virtually no precedent in Wisconsin’s court system. (No public official has been impeached in Wisconsin since 1853.) 

Even if courts agreed to review the articles of impeachment, the core effect of the GOP’s actions is to affect who sits on the highest court—targeting who gets to even interpret the constitution in the first place. Protasiewicz recused herself this month from a lawsuit asking the state supreme court to block attempts by the legislature to impeach her, signaling that liberals have already lost their edge on the supreme court for cases that touch on her removal.

“It’s a legal question that’s to a greater extent than most floating in this sea of politics,” says Oldfather on the matter of whether impeachment is an appropriate response to the accusations against Protasiewicz.

Vos, the state Speaker, did not respond to a request for comment on these constitutional concerns. On Sept. 13, he said he was setting up an advisory panel made up of former supreme court justices to consider when a justice can be impeached. One of the members is a former conservative justice and former Republican lawmaker who donated to Proasiewicz’s opponent.

West Virginia’s GOP in 2018 similarly tested the bounds of their power once they had the votes. “Impeaching the entire court was entirely political,” says Robert Bastress, professor at the West Virginia College of Law, “it was motivated by Republicans who had just recently taken over the legislature, and they were flexing their muscle.” 

The overhaul of West Virginia’s supreme court dates back to 2018, when Chief Justice Allen Loughry, a Republican, was federally indicted on fraud and witness tampering charges that stemmed from allegations of him using state funds for his personal enjoyment and spending excessive amounts of money on furnishing his office. A concurrent fraud scandal also engulfed Justice Menis Ketchum, a Democrat. By mid-2018, Ketchum had pled guilty in a federal case and resigned, and Loughry was suspended from the court. 

But Republicans also went after the remaining members of the supreme court, alleging in part that they were all responsible for the court’s insufficiently clear ethics policies. 

“They had very good reasons for impeaching two of the justices—two of them were convicted of federal felonies—there were no grounds for impeaching the other three,” Bastress says. 

Workman stood her ground after her impeachment and fought the proceedings until a panel of state judges blocked the Senate from holding a trial and ruled that the legislature was violating procedural requirements in its impeachment proceedings. The state Senate, which by then had acquitted the GOP chief justice and was gearing up for a trial against Workman, fought the ruling but the U.S. Supreme Court let it stand. As a result, Workman got to stay on the court, though she then chose not to seek re-election in 2020. 

But by the time a court intervened to stop West Virginia’s impeachment trials, another Democratic justice, Robin Davis, had already chosen to resign rather than let the proceedings against her drag out. To replace Davis, Governor Jim Justice appointed Evan Jenkins, one of the state’s Republican U.S. representatives. 

“What the legislature was attempting to do was to stack the court with what I would call their puppets,” Davis told Bolts. “They were hell bent on getting control of the court.” She says she did not want to participate in what she viewed as “a very unfair, highly political proceeding.”

Unlike West Virginia in 2018, Wisconsin is a closely divided swing state with obvious stakes for national politics, making it likely that a judicial impeachment would receive far more attention and become a magnet for fundraising and political activism. That also gives Democrats an additional avenue to respond: activating public opinion.

In an interview with Bolts, Ben Wikler, chair of the Wisconsin Democratic Party, stressed that he is focused on putting pressure on Republican lawmakers. Democrats have also launched a multimillion-dollar campaign to air ads on this situation. 

“Our number one goal in the first phase of this fight is to make sure that every Wisconsin voter knows Republicans are threatening to overturn the election, and to encourage them to contact their legislators to let them know how they feel about it,” Wikler says. “It’s going to remind voters exactly why they voted for Democrats in the midterms and threw out Trump in the first place, which is that the Wisconsin Republicans are a clear and present danger to democracy.”

Politically-speaking, Democrats’ strongest asset in the confrontation over their new supreme court majority is the governor’s mansion: If Republicans manage to remove Protasiewicz, Evers would have the power to appoint a new justice to fill the vacancy, and he would presumably pick another liberal-leaning justice to replace her.

Vos and his allies may still be thinking it’s worthwhile to float impeachment because the threat alone could persuade Protasiewicz to bow to their demand and recuse herself on at least redistricting cases; Protasiewicz has not at this stage indicated what she would do. In addition, if they do impeach and convict Protasiewicz before Dec. 1, it would trigger a special election in 2024, giving conservatives a shot to flip back the court next year. 

Still, even if there is an election in 2024, Evers’ interim appointment would sit on the court for long enough that the court would have time to strike down gerrymanders.

To tie Evers’ hands, Republicans may turn to a very aggressive maneuver. If the Assembly impeaches Protasiewicz, it would suspend her and therefore deprive liberals of their majority until the Senate holds a trial that results in either an acquittal or conviction. But the Senate could indefinitely delay trial on the articles of impeachment and keep Protasiewicz sidelined without allowing Evers to appoint a replacement. The state constitution sets no timeline for how quickly the Senate has to take up articles of impeachment. 

“It’s one of those situations where the constitution assumes good faith, regularity of proceedings, and doesn’t spell it out,” Oldfather says.

Protasiewicz could still try to sue to force a resolution, some legal observers say. But here again, she and state Democrats also have political leverage that may prove more important than possible lawsuits. 

At any moment, Protasiewicz could break the logjam by resigning, allowing Evers to appoint a replacement even if at a personal cost to her. In a bizarre twist due to the particularities of state law regarding the timing of elections (there can be no more than one supreme court seat on the ballot on any given year), if Protasiewicz resigned on or after Dec. 1, Evers’ replacement appointee would get to serve until 2031 without facing an special election (seats on the court are currently scheduled for re-election each year from 2025 to 2030)—hardly an appealing prospect for the GOP. 

Seifter, the University of Wisconsin professor, also envisions a scenario in which Evers could claim the authority to appoint a justice if the Senate is delaying a trial.

“It’s hard to say how the courts or other actors will respond in this unprecedented situation,” says Seifter. “For example, the governor could declare that the legislature’s inaction creates a temporary judicial vacancy, or a court—whether the high court or a lower court—could reject the holdup as an encroachment on the judicial function. There isn’t clarity at this point on who would have the final word.”

Republican lawmakers this week also introduced articles of impeachment this week against the state’s elections chief, Meagan Wolfe, whom they have been aiming to fire all summer. The charges against Wolfe stem largely from conspiracies about the 2020 presidential election that have been debunked. Either Protasiewicz or Wolfe would be the first Wisconsin official impeached in roughly 170 years.

Such extraordinary events, if they unfold in coming months, may also ratchet up what other politicians are willing to consider in other states. Republican lawmakers in Montana, Ohio, and Pennsylvania in recent years have talked about impeaching state supreme court justices whose decisions they disliked, but have ended up not moving forward. 

“You see states learning from one another and adopting the strategies that legislators have found successful in other states to gain an upper hand in their courts,” says Keith of the Brennan Center. “And so if this happens in one state, I would not be surprised to see other states follow.”

The post With Impeachment Push, Wisconsin GOP Tests Bounds of Political Power appeared first on Bolts.

Jenny had been locked up for several years by the time Ujevich arrived at West Virginia’s all-women Lakin Correctional Center and Jail. There, Ujevich says, Jenny had complained of a persistent pain in one of her breasts, but struggled to get staff to take that problem seriously. In fact, Ujevich says, the staff hardly paid her any mind until Jenny’s condition sharply and visibly worsened. Only after that point did Jenny learn she had breast cancer. 

Ujevich still fumes over how long it took Jenny to obtain that diagnosis, and over what came next: “She couldn’t get her chemo on time,” Ujevich told Bolts.

Jenny was released in late 2016. She spent Christmas with her family, then died in January.

Ujevich is now free and heading a nonprofit project called West Virginia Family of Convicted People, where she advocates for changes to the state’s prison system, including improvements in health care. She’s nervous that a new state law, passed during a special session last month by West Virginia’s GOP-run legislature and signed by its Republican governor, could lead to more cases like Jenny’s.

Senate Bill 1009 bans the use of state funds for any health care for incarcerated people that isn’t deemed “medically necessary.” The policy leaves it to state Corrections and Rehabilitation Commissioner Billy Marshall—a career law enforcement agent who has said incarcerated people are lying when they allege inhumane treatment by the state—to define “medically necessary” and makes clear that this definition can supersede guidance from health professionals. “A provider of health care prescribing, ordering, recommending, or approving a health care service or product does not, by itself, make that health care service or product medically necessary,” the law reads.

West Virginia already routinely fails to provide basic, essential care in its jails and prisons, several formerly incarcerated people told Bolts. Kenneth Matthews, who was locked up for more than eight years and has been free since 2020, says he lived this firsthand, as a diabetic person with high blood pressure. 

In prison, he said “I didn’t get insulin, and they didn’t give me medication for my high blood pressure either. They said maybe if I lost some weight and worked out more, my blood pressure and diabetes would correct itself.”

And Zoey Hott, a trans woman who was incarcerated for about 18 months and released August 1, said people needing gender-affirming care feel this struggle acutely. She told Bolts she was promptly taken off hormone therapy when she arrived at jail and then denied this treatment as she was transferred to several different jails. The interruption, she said, caused physical discomfort and profound mental health issues. 

“It took me five months to even be evaluated,” Hott added. “They don’t really look at it as something of significant importance for anybody. I feel like they view it as an elective procedure.”

Stories like these abound, JoAnna Vance, an organizer with the West Virginia Economic Justice Project, told Bolts. “Health care in jails and prisons is not good. ‘Mental health services’ is just throwing people in solitary. We just had another death in one of our jails this morning. I know people who’ve been having seizures in jail and the correctional officers ignore them or tell the other inmates to deal with it. Lord, there’s so much.” 

West Virginia contracts with a private company, Wexford Health, for medical care in its jails, prisons, and juvenile detention centers. All over the country, from Arizona to Illinois to West Virginia, incarcerated people and their advocates have complained for years of medical dangers resulting from government partnerships with Wexford. Most recently, a lawsuit filed in July accused the company of denying thousands of incarcerated West Virginans medication for opioid use disorder. 

In the treatment of addiction and so much else, health care in U.S. carceral facilities is typically abysmal—even as the people locked in those facilities are, on average, much more medically vulnerable than the population at large. The situation grows even more dangerous where care is outsourced to private companies, like Wexford, a broad Reuters analysis found.

But even against this national backdrop, West Virginia stands out: it led the nation in prison deaths per capita in 2020, and, that same year, the Reuters analysis found that its jails had the highest death rate between 2009 and 2019, among dozens of regions around the country that the news agency surveyed.

And so it is alarming to those critical of this deadly system that the state has passed a new law that could soon curtail what little public funding the state currently allocates for health care in jails and prisons. Advocates worry now about what SB 1009 will mean for incarcerated people seeking gender-affirming care, contraception, disability accommodations, or anything else the state might try to argue is not “necessary.”

“I think this has the potential to be extremely abused. I really do,” Ujevich said. In West Virginia jails and prisons, she added, “They just do not give a shit about your medical care. Not one shit.”

It’s hard to know how, exactly, SB 1009 will change the status quo. The enrolled bill is less than 500 words long and leaves many blanks to be filled. Notably, it does not specify any forms of health care that are being provided today that might be eliminated under this policy and leaves broad authority to the state Division of Corrections and Rehabilitation to set new rules moving forward. 

And while the law does require the division head to consult with a “medical professional” before deciding whether a given instance of medical care is indeed “necessary,” it neither defines “medical professional” nor compels the division to accept professionals’ advice.

Delegate David Kelly, the Republican chair of West Virginia’s House Jails and Prisons Committee, told Bolts the point of the bill is to make carceral health care rules uniform across the state system—that is, he said, whether or not someone receives a certain type of medical care while locked up should not depend on their facility. But he was unable to say whether there is a lack of uniformity in the system today, and could not identify any particular procedures or benefits the state funds today that he believes should not be covered in the future.

With few specifics written into the law and such broad powers granted to prison officials, a dozen different lawyers, lawmakers, advocates, and formerly incarcerated people interviewed for this story told Bolts the best they can hope for is that the policy change won’t much affect West Virginia’s standard of care in jails and prisons. But, “worst-case scenario, it will prevent even more medical care for incarcerated people,” said state Delegate Mike Pushkin, a Democrat who voted against SB 1009.

Pushkin and several others said they believe this law could open West Virginia to lawsuits. Recent successful litigation accused Corrections officials of inadequate medical and mental health care, and a new suit filed this month in federal court alleges 10,000 people in the state’s custody live in inhumane conditions.

“The United States constitution sets the minimum floor as to what the state has to provide to people who are incarcerated, and there’s no statute that the West Virginia legislature could pass that would somehow remove that obligation,” said Lydia Milnes, deputy director at Mountain State Justice, which has sued the state over health care for incarcerated people. If SB 1009 leads West Virginia officials to deny even more basic health care in jails and prisons, Milnes said, “There can and will be more litigation.”

SB 1009 could also be a cost-saving measure for a state jail and prison system dealing with critical staffing issues—Commissioner Marshall said over 1,000 positions are vacant in West Virginia jails and prisons, twice as many as before the COVID-19 pandemic—that advocates say contribute to the state’s deadly carceral conditions. But the special legislative session last month resulted in much more discussion of pay raises for jail and prison staff than of ways to ensure safety and wellbeing for incarcerated people.

“I think they’ve barely chiseled away at the edges,” said Pushkin, one of just 11 Democrats in the 100-member state House. “You need safe places for people who are incarcerated. And we don’t have that here in West Virginia.”

Republican Governor Jim Justice called the special session, which began on the same afternoon he announced it. SB 1009 was one of the 44 bills that Justice included on his call, directing the legislature to take it up.

He requested for the session to begin at 4 p.m. on a Sunday, and some state lawmakers told Bolts they didn’t get a peek at the legislation being proposed until about 3:30 p.m. The process left many people directly concerned with or affected by the slew of legislation no time to assess it, much less to testify on it. 

“The lack of transparency during the special session was completely appalling, and it’s not the way democracy is supposed to work,” Pushkin said.

Kelly, the Republican delegate, pushed back, telling Bolts that SB 1009 had been brainstormed for “several months.” If so, that’s news to many people who work closely on and are directly affected by the issue of health care in jails and prisons in West Virginia.

This policy change concerning “medically necessary” care received only one public hearing before it became law, in a 35-minute discussion of the House Judiciary Committee. The Republicans backing the bill made little effort to identify the need for this change, and Brad Douglas, the executive officer of the Division of Corrections and Rehabilitation, offered little information when he testified under oath. 

In a private meeting the day the special session began, the Republican legislative leadership said this reform was needed “because of nose jobs and knee replacements” for incarcerated people, Democratic state Delegate Evan Hansen told Bolts. “They did not present any backup data or evidence.”

Among the few substantive public remarks any elected West Virginia Republican has made on this policy, state Delegate Brandon Steele voiced support during the committee hearing for state funds being used on voluntary sterilization of incarcerated people.

“If one of these individuals wanted to get a vasectomy or hysterectomy or something like that, I think that it’s good public policy to allow them to do that,” Steele said, in a remark that went unchallenged at the hearing. (Steele isn’t the first to advocate along these lines: GOP state Senator Randy Smith recently suggested West Virginia should shorten jail and prison sentences for anyone who agrees to be sterilized, so that those people “don’t bring any more drug babies into the system.”)

At one point in the hearing, Democratic Delegate Joey Garcia, who sits on the Judiciary Committee, pressed Douglas to identify any procedure or medical benefit that the state is funding today, but may not fund under SB 1009.

“So, you don’t have any examples?” Garcia asked.

“I do not,” responded Douglas.

Only when asked directly about West Virginia’s extreme rate of jail and prison deaths did Douglas even acknowledge them. “It would be accurate to say we’ve had inmates die in jails, yes,” he said. When asked if that is a “problem,” Douglas said only, “It’s never good if any inmate passes away.” 

SB 1009 passed the legislature the following day. It passed the Senate unanimously, including with support from Democratic members. The House passed it on a margin of 86 to 9, with eight Democrats and one Republican opposing. 

“The guy was playing dumb,” Hansen said of Douglas. “But that happens with a lot of bills in the legislature in West Virginia, now that the Republicans have a supermajority. They work things out in their caucus ahead of time, and it’s very rare for someone from the majority party to slow things down by asking questions.”

For the previously incarcerated people who spoke to Bolts, SB 1009 has reaffirmed their feeling of abandonment by the state and renewed their outrage with what they perceive to be indifference by state officials to the lives and livelihoods of those locked up in West Virginia. 

“It’s horrible, to say the least,” Matthews said. “I think they’re putting a lot of men and women’s lives at risk over the sake of potentially saving some money. Somebody’s life shouldn’t have a dollar amount attached to it.”

Soon after he was released, Matthews was hospitalized with diabetic ketoacidosis, a life-threatening condition. “My endocrinologist told me I should have been on medication for a long time,” he said. “I asked, ‘What’s a long time?’ and he said at least the last five or 10 years. I said, ‘That’s interesting, because I was incarcerated for most of that time.’”

Matthews said that his own experience underscored for him that whether a particular procedure or treatment is considered elective or necessary can depend on the whims of whomever gets to make the call.

“It would have been very easy for them to get me on medication to control this early, but I guess they didn’t feel that it was ‘medically necessary,’” he said. “A lot of guys’ life expectancy is shortened because of this. I could’ve died in my sleep because they didn’t take my issues seriously.”

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“(T)here’s a time where we all have to make a little bit of sacrifice. Our president called us to D.C.,” he told local news at the time. “It was inspiring to be there and I hope he calls us back.”

His loyalty to election denialism has not appeared to harm his political career; he was re-elected last fall after a tight Republican primary and a blowout general election, and, earlier this year, he was named chair of the Senate panel tasked with reviewing election policy. 

Azinger is now one of several election deniers leading legislative committees on election law, including in the battleground states of Pennsylvania and Arizona. Others have been elected to lead state Republican parties in recent weeks.

This takeover of GOP infrastructure by candidates who spread false conspiracies about the 2020 election has continued even since their high-profile losses in the fall of 2022. But in West Virginia, voting rights advocates say Azinger’s appointment to the chamber’s elections subcommittee has barely registered as scandalous. Bolts found this is neither being covered in local media nor inspiring any particular outcry among fellow lawmakers or the general public.

Senator Mike Caputo, a Democrat on the elections subcommittee and the longest-tenured member of his party’s tiny Senate caucus, told Bolts, “The voters in Senator Azinger’s district elected him. They knew what his actions were. That’s just the way it is around here.”

Azinger’s heightened influence over election policy in his state fits neatly within the status quo in GOP-dominated West Virginia, where voting access is relatively restrictive, turnout is among the worst in the nation, and election deniers abound in the halls of power—and specifically in offices with real influence over election policy. 

Republican Secretary of State Mac Warner, for example, appeared at a pro-“Stop the Steal” rally outside West Virginia’s capitol building in December 2020, and was quoted that day saying “it’s important” to keep Trump, who had already lost, in office. Warner is now running for governor.

Republican West Virginia Attorney General Patrick Morrisey signed on to a federal lawsuit seeking to overturn 2020 election results in key swing states won by President Joe Biden, and Warner endorsed the effort.

In January of 2021, both current West Virginia members of the U.S. House of Representatives, Republicans Alex Mooney and Carol Miller, voted to overturn 2020 presidential election results. Miller now faces a challenge from former Delegate Derrick Evans, who was imprisoned for three months in connection with storming the U.S. Capitol and last month announced he is running for Congress.

Eli Baumwell, interim director of the ACLU of West Virginia, is one of those playing defense against the state’s increasingly overwhelming GOP majority. He said it helps obscure Azinger’s appointment to the elections subcommittee that the “fringe” keeps shifting further right in West Virginia on a number of other political fronts, which are taking attention away from elections policy. 

This session has brought a slew of anti-LGBTQ legislation, including House Bill 2007, which seeks to ban gender-affirming health care for West Virginia children. That policy passed the House by a vote of 84-10 and now sits in the Senate, which Republicans control. The House also passed a bill to give state funding to so-called “crisis pregnancy centers,” which discourage people from learning about or seeking abortion—something already near-totally banned in the state. Another bill, passed by the House this week, expands religious exemptions that critics worry will allow organizations to discriminate.

Amid that backdrop, it’s easy for a Senate subcommittee on election policy to go relatively unnoticed.

“We are continually dealing with more and more extreme politicians,” Baumwell told Bolts. “Mere attendance at January 6 isn’t even enough to understand how extreme some of these people are.” 

Asked by Bolts about the reception to Azinger’s subcommittee chairmanship, Julie Archer, of West Virginia Citizens for Clean Elections, said, “I think people care, but also, when I think about some of the issues that some of our partners and allies are dealing with, … there’s just so much bad stuff, and people only have so much headspace for outrage.”

Azinger declined to be interviewed for this story.

Despite his participation in federal election subversion, plus newfound control of the subcommittee gavel, Azinger this year did not champion much in the way of legislation on elections, the state’s log shows. 

The most controversial bill he has sponsored on this front, Senate Bill 516, would make it easier for dark-money political donors to donate in even higher amounts. The bill passed the Senate earlier this month, and currently sits in the House.

Other Republican lawmakers filed a pile of legislation that worried voting rights advocates, including bills to refer voter fraud cases to the (pro-election subversion) attorney general instead of to local prosecutors; to make state voter ID laws stricter; and to repeal the state’s automatic voter registration programs. 

The package is all but dead—it would take an unexpected suspension of legislative rules by GOP leaders to revive it—with West Virginia’s legislature set to adjourn its session in less than two weeks. That’s in keeping with Republicans’ recent approach on elections policy: one nonpartisan evaluation of West Virginia’s 2022 session found the legislature was “restrained” on that front. 

That Azinger and his party aren’t doing more to restrict the vote may be explained by the fact that Republicans are more likely to pass legislation in this area in states with closely contested general elections. West Virginia is hardly competitive; Trump beat Biden there by nearly 40 percentage points in 2020, and Republicans won nearly 90 percent of legislative seats in November.

Analyzing voting-access legislation around the country, researchers out of the Massachusetts Institute of Technology and Spelman College found last year that, “among Republican-dominated states, the most active legislatures were those in which the 2020 presidential election was close.” They add, “legislative activity to expand or contract the electorate has often been motivated by electoral threat.”

Still, West Virginia generally ranks among the worst states for voting access, according to several nonpartisan groups. It does not provide no-excuse mail voting, ballot drop boxes or same-day registration. While it was an early adopter of automatic voter registration, implementation was repeatedly delayed, which Azinger supported, and voting rights advocates say the existing program is hardly effective.

According to the U.S. Elections Project, West Virginia voter turnout was fourth-lowest among states in 2020. Last November, West Virginia turnout was second-lowest in the country, at under 36 percent.

Azinger, in fact, may be more open to certain measures that might expand the state’s paltry electorate. Kenneth Matthews, a formerly incarcerated West Virginian working to restore voting rights for people released from state prisons on parole or probation, said Azinger at one time indicated he might support that policy, Senate Bill 38. Still, the Senate subcommittee on elections did not hold a vote on the bill, despite holding a hearing, before a legislative deadline.

“He applauded me for the efforts I’ve put in for my re-entry,” Matthews told Bolts, “and he said he’s glad I’m up here advocating and letting my voice be heard.”

Azinger has also not questioned the legitimacy of results within West Virginia. Around the country, election-denying Republicans are often more trusting of election systems, and open to liberalizing them, in their own jurisdictions. In rural Nevada, for example, a county elections chief this month told Bolts she is routinely hounded in her own community about election security—but that those questioning her usually are upset about other counties. And in Cochise County, Arizona—a hotbed of election-denier activity—Votebeat reported this month that the local elections chief “defended his own county’s election but couldn’t defend elections elsewhere in the state.”

Regarding the disconnect between Azinger’s more muted approach to elections in West Virginia and his proudly conspiratorial views on federal elections, Matthews notes that “it’s easier to see the weeds in your neighbor’s yard than your own, sometimes.”

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