Medicaid Expansion Town Hall Meeting

Nearly fifty people were in attendance for Senator Louise Lucas' Town Hall Meeting on Medicare expansion last evening.  In addition to Senator Lucas (center), last night's panel included Delegate Roslyn Tyler (center right); Dr. Jennifer Lee, Deputy Secretary of Health & Human Resources for Virginia (center left); Gaylene Kanoyton, President of Celebrate Healthcare (far right) and Steve Ramey, Chief Financial Officer from Southampton Memorial Hospital (far left).  Republican Members of the General Assembly invited to join Senator Lucas were Senator Frank M. Ruff, Jr., Senator John A. Cosgrove, Jr., and Delegate Richard L. Morris.  None of the Republicans even bothered to show up.

After Senator Lucas made introductions Dr. Lee gave a power point presentation outlining the benefits of expanding the Commonwealth's Medicaid Program.  The Power Point included images of a recent Remote Access Medical mission in Wise County, Virginia.  Dr. Lee described how nearly 2000 people spent the weekend in line and sleeping in their cars in order to have access to the only medical appointment they would have THIS YEAR.  The RAM mission also included a dental clinic where 750 people had full mouth extractions.  Those 750 people were entered in a lottery for dentures, only 50 names were drawn.  50 people out of 750 people were able to be fitted for dentures, but those dentures will not be delivered until next year's RAM mission.

Had obstructionist Republicans in the General Assembly allowed Medicaid Expansion to move forward in January, clinics like the one in Wise County would no longer be the only access to medical care for an entire county.

Medicare Expansion is fully paid for by the Federal Government, and will continue to be fully funded until 2016.  Medicaid Expansion is fully funded by a combination of savings and tax increases on people making $250,000 or more per year.  The savings are cuts in funding to hospitals for, among other things,  indigent care; care that would still be covered under Medicaid.  For states that are not expanding their Medicaid programs hospitals are not able to recover the costs of that care.  The Patient Care and Affordable Care Act, as written,  was balanced; until the Supreme Court of the United States made Medicaid expansion optional (in a 5-4 decision along party lines).

As Virginia's Medicaid Programs stands now, only people that make 30% of the Federal Poverty Level, about $8,000 per year for a family of 4, qualify.  Adults without children, regardless of income, are barred from the Medicaid program.  Currently the costs of the program are shared 50/50 by the State and Federal Governments.  Under expansion, any individual making 133% of the Federal Poverty Level will qualify for Medicaid.

After Dr. Lee's presentation Steve Ramey of Southampton Memorial Hospital spoke.  Mr Ramey talked about how fiscally difficult it will be for hospitals to continue to operate in this climate.  Hospitals are still legally and morally obligated to treat patients, but without Medicaid expansion, they are not able to be paid for that care.  The federal funds that would have paid for that care are one of the funding sources for Medicaid expansion.  Mr. Ramey also stated that "every hospital in the state is in favor of Medicaid expansion."

If Medicaid is not expanded, Community Health Systems will loose $1.7 million over the next two years between the hospitals in Emporia and Franklin.  That is nearly one million dollars per year that will be out of our regional economy.  That loss of funding will, ultimately, result in staffing cuts and cuts in services.  Although not related to Medicaid expansion, Emporia has already seen the loss of our Birthing Center.  Several communities, most notably Belhaven, NC,  have already seen their local hospitals close without expansion.

Republican opposition to Medicaid Expansion is not Fiscally Conservative; nor is it Financially Responsible.   There are some that claim Republicans in the Virginia General Assembly are only opposed to Medicaid expansion in an effort to hurt a program that is a cornerstone of Barack Obama's Presidency (what the Washington Post calls "reflexive determination to oppose the Obama administration’s signature policy" ). The official excuse of Republicans in the General Assembly is a supposed lack of trust in the Federal Government.  Not only do they actually think that the Federal Government will suddenly change their minds and stop paying 90% of the costs, they also think that paying %10 an undue burden. 

Weather the opposition stems from some unfounded fear or Republican hatred of the President, The bottom line is that Medicaid Expansion is the only way forward.  The program will be fully paid for until 2016, and after that funding will drop until 2020.  Even after 2020 the program will still be funded at 90%, with the state only paying 10%.  Over the next 8 years the $14.6 BILLION Medicaid expansion will also create 30,000 jobs for Virginians.

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