What the heck is Medicaid Expansion anyway?!

TrumpCare is dead (!) so you might be wondering right now what exactly Medicaid is and why we’re talking about expanding it in Virginia. Good question! Let’s get some answers.


Why are we having this conversation?

The Affordable Care Act, otherwise known as Obamacare, gives states the option to expand eligibility for their Medicaid programs to cover individuals who don’t make enough money to qualify or be able to afford subsidized health insurance from the marketplace. Lots of states have taken advantage of this offer because 1) it makes sense to cover more people and 2) the feds will pick up no less than 90% of the cost. Even red states like Arkansas and Louisiana have expanded their Medicaid programs because they know that when their residents get sick, they should be able to see a doctor, without having to choose between food, rent, or doctor’s’ bills.


So what is Virginia doing?

Up till now, Virginia has done a whole lot of nothing. Or, to be more specific, Republicans in the House of Delegates have basically said, “Obamacare? We don’t need no stinking Obamacare!” and turned up their noses at the federal government’s offer to pick up the tab. They’ve said no A LOT. Every year since 2012, in fact. They’ve rejected straight proposals to expand eligibility for the program. They’ve rejected compromise proposals from state Senate Republicans to cover Virginians in more creative ways. House Republicans have rejected even thinking about potentially expanding Medicaid in the future. Basically, their reaction to Obamacare and the possibility of expanding Medicaid can be summed up like this:

Lt. Gov candidate Glenn Davis gets it with his light saber


I got it. House Republicans hate Medicaid Expansion. What’s different now?

Do you remember Friday when Donald Trump and Speaker Paul Ryan were forced to pull their Trumpcare bill because, in the immortal words of Lin-Manuel Miranda’s Hamilton, “you’re gonna need congressional approval and you don’t have the votes”?

Paul Ryan doesn’t have the votes either.

Yeah. Right after that happened, Paul Ryan uttered what is definitely my favorite quote of the year. Let’s go to the video.

“Obamacare is the law of the land. It’s going to remain the law of the land until it’s replaced. We did not have quite the votes to replace this law. And so, yeah, we’re going to be living with Obamacare for the foreseeable future.”

SO GOOD. But, beyond the moral victory, this is actually really important to what’s happening in Virginia. See, a key part of Virginia Republicans’ argument against Medicaid expansion has been that we can’t count on the federal government. Republicans have been biding their time until they had the votes to repeal Obamacare so why do anything optional under the law in the meantime? On Friday, we learned they will never have the votes (see the awesome Hamilton quote above). Republicans control the House of Representatives, the U.S. Senate, and the White House. For the better part of a decade, they’ve told us that if they just have a little more power, they’d repeal Obamacare and replace it with something really awesome. They were so serious about this plan, they staged over 50 meaningless votes to repeal the law while doing exactly zero work to figure out a replacement.

Repeal is never going to happen. Obamacare is here to stay. So what’s next?


On Wednesday, April 5th, Virginia Republicans could vote to expand Medicaid.

On Wednesday, April 5th, the General Assembly will come back to Richmond for one day to consider Governor Terry McAuliffe’s vetoes and proposed bill amendments. On the list is an amendment from the Governor to expand Medicaid in Virginia. Every member of the House of Delegates will have the opportunity to vote yes or no in a recorded vote. They will get to decide yet again whether it’s time to fully implement Obamacare in Virginia and ensure every family has access to quality, affordable health care or if petty political games are still their priority.


Who benefits from expanding Medicaid?

Medicaid expansion would benefit 400,000 Virginians by closing the coverage gap.

Right now, there are up to 400,000 Virginians who fall into what we call the “coverage gap.” They make too much money to qualify for health insurance through Virginia’s very restrictive Medicaid program. How restrictive? If your family of 4 makes $11,000 a year, Virginia thinks you make too much money to qualify for Medicaid. But, that same family doesn’t make enough money to qualify for government subsidies to help afford a private health insurance plan purchased through the marketplace. They literally fall into a gap in coverage.

People in the gap are working–they’re parents and veterans and often raising families. Mercedies lives in the Shenandoah Valley. He’s a veteran. And he’s in the coverage gap.

Mercedies’ story isn’t unique. You can visit I Am The Coverage Gap to hear and read more stories from Virginians whose health care coverage is on the line on Wednesday.


What can I do to help?

I’m so glad you asked! Can you contact your state Delegate and Senator and ask them to expand Medicaid so Virginians can see a doctor when they need one?

Make the Call for Medicaid Expansion
Romy wants you to contact your state legislators.

Ok. I can’t actually give you a phone through this website, but I can get pretty darn close. We’ve set up an easy page to give you everything you need to contact your state legislators to advocate for Medicaid expansion. Just put in your address and we’ll find your representatives. Go get your advocacy on!