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An Update on Expanding Access to Healthcare

February 1, 2018

Several days ago, I participated with four other legislators in a town hall meeting with our constituents. It was my sixth such meeting to solicit opinions of constituents for this General Assembly session.

We took dozens of questions from our constituents. Toward the end of the meeting a woman asked a question that stumped us all: "Why are the Republicans opposed to expanding Medicaid in Virginia?"

We had no answer for her. We couldn't come up with any reason other than that they oppose "ObamaCare."

We know the advantages of expansion:

  • 50,000 to 400,000 Virginians, most of them working in low-paying jobs, would receive medical care.
  • About 30,000 well paying jobs would be created.
  • Virginians would re-coup billions of dollars each year that we send to Washington but do not get back.
  • Our hospitals, especially our rural hospitals, would become financially stable.
  • We would have sufficient resources to help Virginians fighting addictions and mental illnesses. Currently we do not have those resources and, short of increasing taxes, will not have them.
  • We would free up about $425 million in state funds that could be diverted to other priorities such as education and public safety.
  • We also know opponents of expansion used to have specific objections.

There was a belief that our Medicaid program was not well managed. So, we set up the Medicaid Innovation and Reform Commission to improve the system. I served on the Commission and am proud to say that our program is now recognized as one of the best run and most frugal in the country. And our outcomes have improved dramatically.

There was a fear that the federal government would withdraw and leave us with the bills. So, we got a letter from CMS (Centers for Medicare and Medicaid Services) saying if the federal government was not living up to its commitments, we could withdraw from the program. And, as all other states have done, we would put in the law that the program would be terminated if federal funding were altered.

There was a concern that we could not afford the state share, which will be a maximum of ten per cent. We have developed a plan whereby the hospitals will pay the state share.

We now know the benefits of expansion and have answered all articulated objections.

We recently are hearing new objections. For example, there is currently a demand that there be a work requirement. We are willing to try to find a compromise on that.

I need an answer for my constituent. "Why do the Republicans oppose expanding healthcare for Virginians?" I told her I would ask.