There’s no more pressing issue for the General Assembly this year than expanding Medicaid to provide quality, affordable healthcare to up to 400,000 Virginians. When you get sick, you should be able to see a doctor without having to choose between paying your medical bills or your rent. There’s been a lot happening in Richmond recently on this issue: bills rejected in the Senate, demands from Republicans to implement so-called “work requirements”, and lots of rhetoric back and forth. So, where do we really stand?
What is Medicaid Expansion?
The Medicaid program provides insurance to people who are low-income, pregnant, or disabled. There are, however, people who are not poor enough to qualify for Medicaid, and yet can’t afford to pay for their own health insurance. These people are left without insurance—in a “coverage gap”. In an effort to close this gap, the Affordable Care Act allows the federal government to pay the lion’s share (90%) of the cost for states—including Virginia—to expand their Medicaid programs to cover those caught in the coverage gap. To date 31 states have expanded their Medicaid programs. Virginia has not.
You have to be very, very poor to get Medicaid in Virginia right now.
Right now, Virginia has one of the most restrictive eligibility thresholds in the nation to qualify for Medicaid coverage—families must be very, very poor to qualify. How poor?
A family of three making just $11,000 a year makes too much money to qualify for Medicaid in Virginia right now.
Expanding Medicaid by allowing more poor people to qualify would mean accepting people who make up to 133% of the federal poverty line. Here in Virginia, there are up to 400,000 Virginians in that coverage gap.
Medicaid expansion saves Virginia money
Not only would expanding Medicaid give today’s 400,000 uninsured Virginians health coverage, but it would save the state hundreds of millions of dollars in unreimbursed healthcare costs when those uninsured people wind up in emergency rooms for routine care.
So where does Medicaid expansion stand, exactly?
Last week, the Senate Education and Health Committee defeated three proposals to expand Medicaid, including one proposal from Republican Senator Emmett Hanger. However, that doesn’t spell the end of Medicaid expansion—it is still very much alive and a real possibility this year. Why? Because there is another way to pass Medicaid even if individual bills aren’t passed: the budget. Virginia’s budget isn’t just a fiscal document—it’s a policy document that trumps all else. If Medicaid expansion is included in the budget the General Assembly sends the Governor, it doesn’t matter if they don’t pass a standalone bill.
How Medicaid expansion can pass via the budgetary process
Virginia’s budget process is long and pretty opaque. Right now, members of the Senate Finance and House Appropriations are negotiating with each other and with the Governor about what should be included. They’re working from a budget draft submitted by outgoing Governor Terry McAuliffe that already includes Medicaid expansion and uses savings from expansion to do some great things, like raising teacher pay. The House and Senate’s budget will be unveiled in late February and then they’ll continue negotiations to come to a final decision on what they want to send to the Governor.
Support 400,000 uninsured Virginians: Act now!
So let’s demand that our elected leaders continue to negotiate in the interests of their constituents.