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Column: Medicaid Expansion Takes Center Stage

During last Thursday’s budget debate, the General Assembly considered the budgets proposed by each chamber. The biggest sticking point continues to be Medicaid expansion, which the Senate budget included but the House budget did not. I vigorously support Medicaid expansion because it’s critical to the 400,000 individuals who could obtain health insurance coverage and would create as many as 30,000 new healthcare jobs.

As required by federal law, Medicaid currently covers “mandatory eligibility groups” such as children and pregnant women and gives states the flexibility to cover “optional eligibility groups.” In Virginia, this includes a small fraction of disabled adults not needing long-term care services and working parents with incomes less than 138 percent of the federal poverty level (FPL). All childless adults making less than 138 percent of the FPL and many more disabled adults and working parents would now be eligible for coverage. The expansion would allow individuals with incomes below $16,105 (or $32,913 for a family of four) to qualify. Without the expansion, many of these individuals will wait to go to the emergency room to receive care. The costs of ER visits by the uninsured are passed on to insurance companies and patients in the form of increased premiums, driving up costs for everyone.

Each day Virginia delays, we lose $5 million we would have otherwise received from the federal government — that’s over $250 million forfeited since Jan. 1. That $5 million per day could pay for 40,000 patient visits, 119,000 mammograms or 7,200 colonoscopies. By expanding Medicaid, we would cover over 33,000 workers in the tourism industry; 26,000 in the retail trade sector; 23,000 in education, health and social services sectors; 18,000 in the construction industry; and 12,000 veterans.

Hospitals and business associations around the state strongly support Medicaid expansion because they know it will save money and save lives. Last week I heard from representatives at Inova’s Mount Vernon Hospital about one patient, a working taxi driver, who suffered a stroke in his 40s and who was unable to afford insurance. Inova was able to provide for his acute care needs and rehab, but due to a lack of coverage he didn’t get all the post-stroke care he needed and thus took longer to recover — maybe never reaching the capacity he would have with adequate coverage.

Fortunately, a solution is within reach in the form of Marketplace Virginia, a modified version of traditional Medicaid expansion. Marketplace Virginia is similar to what Arkansas has successfully adopted and would provide individuals who would otherwise be eligible for coverage under traditional expansion with the ability to purchase health care coverage through a competitive network of private health plans. This program would be tailored specifically to our state and represents our best chance to close the coverage gap.

You can email me at district30@senate.virginia.gov with your views on legislation. I am also active on Facebook and Twitter (@AdamEbbin).

It is my continued honor to represent the citizens of the 30th Senate District.