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Medicaid expansion and why it matters in Virginia


400,000. That is the number of Virginians that are estimated to be insured through Medicaid should the commonwealth decide to expand its Medicaid program. Lets put some numbers on that 400,000. These are people whose income levels are between 0 and 133% of poverty. In dollar terms that is $0 – $15,282 for a single individual and $0 – $31,322 for a family of four. Does anyone think that a single individual making $15,282 can afford any type of insurance? The answer is not only “no” but “Hell no”. Yet, it remains an ongoing discussion in this state. “Why” you may ask? Simple, its the most conservative element of Virginia’s General Assembly, the House of Delegates. It is somewhat amazing that the two rotating chairs are both from the Shenandoah Valley, Emmett Hanger from the Senate and Steve Landes from the House. Right now there is a split. The Senate is more inclined to reach some accommodation for expansion while the House is opposed. Think the US Senate and House. The House seems to be dominated by ideologues (or tea party types) while the Senate and its moderation is more of a traditional reflection of Virginia politics. How would you like to have the power to influence whether 400,000 needy Virginians got health insurance? The Staunton News Leader has stated that the failure to expand Medicaid is “immoral” yet Steve Landes has suggested that it will never be expanded! It seems that Landes’s major argument against expansion is that the Federal Government may decide not to foot as much of the bill as they have suggested they will. In other words, he is basing his opposition on “ifs” and “buts”. My response to this would be there is a chance if I leave my house everyday something could happen to me. However, that doesn’t prevent me from leaving my house. Medicaid expansion WILL create more jobs because it will provide reimbursements to hospitals and community-based centers that provide services to the uninsured that are used to getting very little or nothing in reimbursement. What happens when organizations, especially non-profits get more revenue? They hire more staff, give staff needed raises or purchase items and equipment that they need to become more efficient. That puts more money into our economy. More money into the economy means more jobs. Who cares if it is federal money, state money or private sector money? The result is the same. A New England Journal of Medicine study concluded that after two years, the expansion of Medicaid benefited the population – “Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services, raise rates of diabetes detection and management, lower rates of depression, and reduce financial strain”. Diabetes and diabetes related conditions account for almost 20% of all hospital admissions. Doesn’t it make sense to treat these people in primary care environments rather than as inpatients in a hospital? The Staunton News Leader is correct, it IS immoral not to expand Medicaid. Everyone who calls themselves a Christian and many that do not know the story of the Good Samaritan. Those who oppose Medicaid expansion are those that choose not to see the person in need along the road. They are not going to help. They are in a position to make the most significant and important decision of their legislative careers and instead they are going to be swayed by a minority of ideologues who never care about those less fortunate than themselves. Together, we can “heal the sick, feed the hungry, clothe the poor”.

  • Quizzical

    In support of the above, I would like to offer an article entitled “Five Lessons from Massachusetts About Obamacare Rollout.”  http://www.kaiserhealthnews.or

    Take this quote for example:

    A dramatic increase in first enrollment put a strain on doctors and health care services at every level. When the “Connector” opened for business in late 2006, people signed up much faster than projected. Within a year there were 367,000 newly insured citizens.

    The same thing would happen in Virginia.  Health care providers at every level would be seeing more patients and in many cases that would require hiring new staff.

    Patients, many of whom had not had insurance for years, had a lot of problems they hadn’t taken care of and were seeking more tests, surgery and other treatment that drove up costs.

    Not only would there be hundreds of thousands of newly insured citizens, that same population has been putting off treatment that they cannot afford. There is a lot of pent up demand.  

    And it can’t be denied that some of those citizens who are ill, will be very hard workers and economically productive when they get treatment.

    It seems like a no-brainer for Virginia to accept the Medicaid expansion.  As the Medicaid expansion will be 100% funded by the federal government for the first three years, by refusing the expansion of Medicaid, Virginia is funding the expansion of Medicaid in other States through its federal taxes, but not getting that same benefit for its uninsured citizens, and not getting the benefit the increased business activity by health care providers that would result.

    From what I have read, the argument against expanding Medicaid is to the effect that the federal subsidy isn’t guaranteed forever, and it would be an unfunded obligation in the future.  There’s a grain of truth behind that argument — the federal funding of the Medicaid expansion is going to drop to a 90% level by 2020.

    Regardless, to me it makes no financial sense to refuse 100% federal funding of the Medicaid expansion for three years, and then 90% or more federal funding out to 2020, to avoid having 10% of the cost in the future.

    The total economic impact (direct and ripple effects of healthcare, business, and household sectors) from opting in is an annual average $3.9 billion and 30,821 jobs from 2014 to 2019, more than four times the economic impact of opting out of the expansion. [Virginia Hospital & Healthcare Association, 12/7/12]