Editorial Opinion: Expand Medicaid Now

Editorial Opinion: Expand Medicaid Now

It’s too late to get back the $10 billion Virginia turned down, but not too late to gain coverage for 400,000 and boost the economy.

Governor’s Perspective

Remarks by Gov. Terry McAuliffe to General Assembly money committees Aug. 21, 2017:

I have called for Virginia to expand Medicaid for three and a half years now. In that time, we have forever forfeited a whopping $10.4 billion of our federal tax dollars.

We have missed an opportunity to cover 400,000 low-income Virginians.

Thirty-one states from across the political spectrum have expanded Medicaid. This isn’t a political issue. These are people’s lives.

I believe in the radical notion that health care shouldn’t be a privilege for the rich. And in the wealthiest nation in the world, one medical event shouldn’t send a family into financial ruin.

Just a few weeks ago, I went to the Remote Area Medical Clinic in Wise for the fourth time as governor. I want to thank Dr. O’Bannon for providing his services at the clinic.

There, you will see the stark reality of what it means to lack access to affordable health care. People were waiting in the animal pens, separated by bed sheet “curtains” to get the only medical care they’d have this year. Many of them slept overnight in the parking lot just to get a spot in line.

I met a woman who pulled me aside to tell me that the clinic literally saved her life by catching her cancer in time. Another man had been driving for a year without proper eyeglasses. Yet another told me that, at 39 years old, he visited the dentist for the first time ever that day. Sadly, he was too late, and needed all of his teeth pulled.

These folks should get the exact same level of care that you or I do.

That’s why I will be including Medicaid expansion once again in my biennial budget proposal this year.

And even if you don’t believe that the ACA is here for good, let me also remind you that in all of the bills proposed in the House and Senate to repeal the ACA, none of them left the non-expansion states better off. In fact, in one of the proposals, non-expansion states would cover costs for the expansion states for the next five years.

So, I ask you this: Are you willing to let Virginia be block granted or capped at our current Medicaid levels? Are you willing to risk losing out on expansion dollars forever? And are you willing to hamper our state finances by turning away these federal dollars, given the uncertainty we face?

I ask you these questions in earnest, and I hope we can find a workable solution together.

I have formally invited General Assembly leadership to meet with my team to start this process as soon as possible so that, perhaps, consensus can be reached in the budget development process.

I welcome your input and I remind you that I have consistently supported a business-like approach that allows us to bring this money back at no cost to Virginia. If you pursue expansion the way I’ve presented it to you, it could save the state hundreds of millions of dollars.

Further, it could protect us from the potential negative financial impacts of future federal caps on the Medicaid program.

It’s not too late. There’s still more than $2 billion a year on the table that we can benefit from, and I hope we can agree on an approach to do the right thing.

Virginia’s General Assembly has refused to accept one of the key provisions of the Affordable Care Act, expansion of Medicaid at almost no cost to Virginia that could have covered 400,000 uninsured Virginians and would have brought more than $10 billion into the state. It has also cost lives.

Ironically, the failed efforts to “repeal and replace” the Affordable Care Act included changes to Medicaid that would have penalized states, like Virginia, that did not expand Medicaid, permanently reducing federal funding.

“In all of the bills proposed in the House and Senate to repeal the ACA, none of them left the non-expansion states better off,” said Gov. Terry McAuliffe on Monday, Aug. 21, in calling again for Virginia to expand Medicaid, almost entirely paid for by the federal government.

“I have called for Virginia to expand Medicaid for three and a half years now. In that time, we have forever forfeited a whopping $10.4 billion of our federal tax dollars,” McAuliffe said. “We have missed an opportunity to cover 400,000 low-income Virginians.”

More than 140,000 residents of Fairfax County have no health insurance. More than 40,000 residents of Arlington and Alexandria have no health insurance. That's more than 12 percent of the people who live in one of the wealthiest areas in the nation.

A Harvard Medical School study determined that the decision by 25 states to reject the expansion of Medicaid coverage under the Affordable Care Act would result in between 7,115 and 17,104 more deaths than had all states opted in. In Virginia, the number of deaths due to failure to expand Medicaid: between 266 and 987.

Refusing to accept federal funds to provide healthcare to uninsured Virginians makes no more sense than declining federal funds for transportation or education.

In Virginia, 102,000 uninsured people with a mental illness or substance use disorder could qualify for coverage if Medicaid were expanded under the Affordable Care Act.

As Virginia wrestles with heroin and opioid addiction, expanding Medicaid would allow for expanding treatment programs. One of the big obstacles to helping people who are fighting addiction is the availability of treatment when it is most needed. More people die of opioid overdoses in Virginia than in vehicle crashes.

It is beyond cruel that an ideologically driven General Assembly can turn away health care for so many. It’s beyond understanding why the General Assembly would turn down billions of dollars in direct health care dollars, plus the tremendous boost to the economy and jobs that federal investment would generate.

— Mary Kimm