Richmond, Virginia—May 30th marks the anniversary of Virginia’s 2019 expansion of Medicaid, which allowed a broader group of low-wage adults access to health insurance. Currently, single adults earning 138% of the federal poverty level (or $21,597 for a single adult) are now able to use Medicaid to see a doctor when they get sick and are able to access basic preventative care. 

On nearly all metrics, Medicaid expansion has been an unqualified success. 630,000 Virginians now have access to health insurance because of the expansion, far more than the 450,000 initially predicted when the legislation passed in 2019.  Medicaid expansion significantly increased insurance coverage for low-income adults and decreased the number of adults who put off necessary care due to costs. When Medicaid further expanded to include dental care in 2021, visits to emergency departments for non-emergency dental care https://progressva.actionkit.com/go/56800?t=6&akid=27892%2E76079%2EhJj-jS(2).pdf”>dropped sharply. Expanding Medicaid also led to a host of other positive outcomes, from an increase in credit scores and a decrease in payday loan borrowing, to a decrease in food insecurity, to an increase in home ownership and a decline in evictions. It has achieved these outcomes while containing costs; in fact, Medicaid expansion has consistently cost less than initially predicted. 

However, with massive looming cuts to Medicaid ahead if the Republicans’ federal budget reconciliation plan passes the Senate, community members who rely on Medicaid for their health insurance are in danger of losing coverage altogether. That is because Virginia is one of nine states that passed a trigger law during the negotiations to expand Medicaid. As a provision of the Affordable Care Act, the federal government agreed to fund 90% of the health insurance costs for states that expanded Medicaid; in Virginia, this means that the federal government pays approximately $5.1 billion into Virginia’s healthcare system.  The trigger law would immediately disenroll people from expanded Medicaid coverage if the threshold that the federal government pays drops below the 90% threshold. The result is that even without factoring in Virginia’s trigger law, 161,614 Virginians are likely to immediately lose Medicaid under the reconciliation bill; 262,400 Virginians in total will lose their health insurance between ACA and Medicaid cuts even if the trigger provisions in the law are paused. 

“It is absolutely unconscionable that in 2025, six years after we finally expanded Medicaid in Virginia, we are now facing the prospect of stripping life-saving health care away from hundreds of thousands of our neighbors,” said LaTwyla Mathias, Executive Director of Progress Virginia. “Medicaid expansion has been one of the most successful, cost-effective public health policies in Virginia’s history. It’s allowed working people to get the care they need, reduced ER visits, lifted families out of poverty, and stabilized communities across the Commonwealth. And now, because of a reckless federal budget proposal and a shortsighted trigger law, we’re at risk of losing all that progress overnight. We should be building on this success, not tearing it down. Our community members should not be used as bargaining chips in a political game. We call on every member of Congress to reject these cruel cuts and stand up for the health and dignity of our communities.”

Background:

• Virginians rely heavily on Medicaid: about 35% of the population uses it as their sole or primary health insurance.  
• More than 1 in 3 births are covered by the program, and close to half of Virginia children are Medicaid-eligible. 
• Those numbers rise dramatically in rural areas of the Commonwealth, and some of the highest percentages of Medicaid recipients live in Southside Virginia, an area that has already been hit hard by rising costs and other federal cuts.