Closing the Healthcare Coverage Gap Saves Virginia Taxpayers
As the General Assembly attempts to complete work in Richmond on the $90 billion state budget, the looming obstacle to an agreement is how to close the health insurance gap or cover uninsured Virginians.
There are an estimated one million uninsured adults in Virginia today or about one in every eight Virginians. The federal Affordable Care Act (ACA) is designed to provide coverage in three ways: (1) require large employers to provide health insurance; (2) create a healthcare exchange to give uninsured adults bargaining power to purchase insurance in a pool at competitive rates, with subsidies for lower-income adults; and (3) expand Medicaid eligibility for all adults whose incomes are 133% of the federal poverty level (FPL) or lower. Under this approach, people would be eligible if their income ranges from around $16,000 for an individual to $32,000 for a family of four.
Medicaid is a proven, federal-state health insurance program for low-income and disabled people. Although Virginia has the eighth highest per capita income in the United States, we currently have the lowest eligibility allowed by law. The only people covered today are low-income children, blind and disabled adults, pregnant mothers and extremely poor elderly in full-time nursing care who have “spent down” all their assets. The federal government pays around half the costs. Under the ACA, the federal government will pay 100% of the cost of the Medicaid expansion in the first four years, declining to 90% of the cost after ten years.
Of all House of Delegate districts in Fairfax County, the 44th District is tied for the largest Medicaid population. It is second in Northern Virginia of all delegate districts. Sixteen percent of 44th district residents are currently covered by Medicaid, including over 9,000 children or one in three children.
Last year, the U. S. Supreme Court held that the ACA is constitutional, but also held that the federal government cannot force states to expand their Medicaid programs. Thus, Medicaid remains optional for states.
In my view, Virginia’s failure to expand Medicaid to the eligible uninsured is political malpractice. Here’s why.
Virginia taxpayers are losing $5 million every day and $2 billion every year that we do not expand our program. This has cost the state $400 million as of Sunday and counting.
Expansion would provide insurance to at least 5,000 adults, create 400 jobs, and return about $24 million to the 44th District alone.
Expanding Medicaid coverage could create 30,000 Virginia jobs.
Closing the gap actually saves Virginia taxpayers over $1 billion over the next decade because the federal government would be paying for services currently covered by the state General Fund, like uncompensated care at university hospitals, prison healthcare and other programs. Expansion could save $280 million in this budget cycle alone.
On Monday, Governor Terry McAuliffe proposed a budget to expand Virginia’s Medicaid program and reapply the savings to other programs. He has proposed a 2% pay increase for teachers, more money for pre-kindergarten education, mental health, land conservation, and to fully fund our contribution to the Virginia Retirement System.
Virginians are currently sending money to the federal government to fund Medicaid expansion in other states like California, Massachusetts, Ohio and Arizona while leaving Virginians’ federal tax dollars on the table.
Expansion will help reign in out-of-control health insurance costs by making preventive care available to people before their illnesses and conditions become exacerbated and more expensive when they cannot pay for care. Today, expenses like uninsured or uncompensated care in hospital emergency rooms are passed along to private insurance payors, thus raising costs for all of us.
Expanding Medicaid is supported by most of the health care industry, the Virginia Chamber of Commerce, the Fairfax County Chamber of Commerce and a bipartisan group of state senators. The only obstruction to making it happen is the Republican Caucus of the Virginia House of Delegates.
Every member of our community deserves the dignity of health care coverage. No one should have to live in fear that an illness will cost them their home or their livelihood.
If you have any feedback, please send me as an email at scottsurovell@gmail.com. It is an honor to serve as your state delegate.
The following is my column that will appear in the Mt. Vernon Gazette and The Mt. Vernon Voice in the week of March 25, 2014.
Why are we adding 400,000 to a Medicaid program where more doctors are already needed so that access times don't increase. It is difficult now to get a doctor to accept Medicaid. Why put this additional burden on doctors who are already so hardworking, running their small business office practice. I hear nothing about adding doctors to the Medicaid program. I thought ACA was suppose to make insurance affordable or be subsidized for all so why the need for more onto Medicaid. Are politicians trying to push more onto a single payer system (government insured plans)? Seems to be the plan they are telling us about. Otherwise, someone tell me why this Medicaid push and not just go on ACA.
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