Mount Vernon Everyone deserves the security of good healthcare and reliable insurance. Americans have chosen a mixed system of public and private health insurance. We have Medicare for the elderly, military health care for our active duty and veterans, and Medicaid, a federal-state program that insures many disabled, low-income, and elderly people, especially people needing long-term care.
The political delay games currently being played in Richmond will hit our community harder than any other part of Northern Virginia. In the 44th Delegate District with 80,796 residents, the 44th District is tied for the highest percentage of Medicaid beneficiaries in the county at 15 percent. One in seven people in the 44th District presently receive their health insurance from Medicaid.
Of those beneficiaries, 74 percent are children, 5 percent are pregnant mothers, 6 percent are poor adults, with the remaining recipients the elderly, blind or disabled. The largest number of Medicaid births at any hospital in Virginia occurs at Fairfax Inova Hospital. Additionally, the 44th District includes a significant population of uninsured individuals compared with the rest of Fairfax County. In the 22306 and 22309 zip codes, visits to the emergency room exceed 434-plus per 1,000 people, mostly for “low acuity” non-emergency problems.
Unfunded medical bills not only affects quality of life for certain families, but uncompensated medical care is passed along to individuals through private health insurance. The health insurance premiums increases for my law firm regularly exceed 10 percent per year.
The health insurance reform has been one of the most contentious battles in this country since its initial proposal by Theodore Roosevelt in 1912. Following the Supreme Court ruling, the action now moves to the states to implement the law.
Health insurance reform, known as the Patient Protection and Affordable Care Act (“PPACA”), principally expanded coverage by two means. First, if states expand their Medicaid programs to all individuals at 133 percent of Federal Poverty Level (FPL), the federal government picks up 100 percent of the cost in 2014-2016, and 90 percent after 2020. Second, states are required to set up healthcare exchanges to make more affordable health insurance available for individuals without employer health insurance benefits, and individuals with incomes between 100 -400 percent of FPL receive a tax credit to help with the cost. Coverage was also expanded by banning coverage denials based on pre-existing conditions and requiring companies to cover college students through age 26.
If individuals do not obtain coverage, then they have to pay a penalty (that the Supreme Court said constitutes an exercise of taxing authority) to the Federal Government. There are also penalties designed to encourage employers to provide coverage.
PPACA also prohibits insurance companies from charging women more than men, and limits the profitability of insurance companies by requiring refunds of excess unused premiums to policyholders — over $150 million to Americans this year alone.
Virginia now has two choices. First, do we set up a health insurance exchange? Second, do we expand Medicaid?
PPACA requires Virginia to set up its exchange by November 16, 2012 or the federal government takes over. Although Virginia’s exchange legislation was negotiated and written last fall, the majority refused to allow it out of committee hoping that the Supreme Court would kill PPACA. Now, to set up an exchange in time we need a special session that will cost taxpayers millions.
I understand that many feel strongly that the PPACA was an expansion of federal power, however, healthcare reform is here to stay. It is time for the General Assembly to stop playing politics with this issue. PPACA is not going to be repealed even if President Obama is not re-elected.
Millions of Virginians, including over 10,000 new people in my district, will be able to afford healthcare by moving forward. The cost to Virginia taxpayers is minor — the federal government is picking up 92 percent of the cost over the next 10 years. Businesses, including our healthcare providers (generally are 16 percent of the U.S. economy), need certainty to make plans and start hiring. The time for excuses is over. It is time to act. It’s time for a special session to implement a Medicaid expansion and an exchange.
If you have any feedback for me on this issue, feel free to contact me at firstname.lastname@example.org. It is an honor to serve as your delegate.