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Medicaid Expansion

Medicaid Expansion – What It Means For Emporia

Emporia, VA – Enrollment for new, low-cost health care coverage for eligible adults will commence in the Commonwealth of Virginia on Nov. 1.

Virginia Governor Ralph S. Northam, MD, has announced that as the date when the state will begin accepting applications for coverage that takes effect Jan. 1, 2019. The best source for information about this new coverage is available at www.coverva.org. On that website, people can access an eligibility screening tool to determine if they are likely to qualify for coverage. Website visitors can sign up to receive regular e-mail or text message updates about new coverage and the enrollment process.

People can also call 1-855-242-8282 for more information. The information phone line for people who are hearing impaired is 1-888-221-1590.

New coverage for adults is available for men and women ages 19-64 who aren’t eligible for Medicare, and who meet income eligibility guidelines, which vary depending on family size. For example, a single adult who earns less than $16,754 in annual income may be eligible. The income threshold for an adult in a two-person household is $22,715. It is $28,677 for an adult in a three-person household, and $34,638 for an adult in a four-person household.

Earlier this year, the Virginia General Assembly and Governor Northam’s Administration achieved a bipartisan compromise to increase coverage for hard-working, low-income adults in Virginia. This coverage, also known as Medicaid expansion, is available under the provisions of the U.S. Affordable Care Act. Virginia elected officials brokered a fiscally-responsible deal that recovers the Commonwealth’s tax dollars, produces millions in state budget savings that free up funds for other important needs, will improve public health and the economy by supporting job growth, and will benefit Virginia taxpayers.

This plan has public support, with polling showing more than 80 percent of Virginians in favor of a coverage compromise, backing from dozens of local and regional chambers of commerce across the Commonwealth, and from the business and health care community. Private hospitals from throughout Virginia are even contributing financial support to help defray any costs the state may incur associated with increasing coverage access.

“When both sides of the aisle came together earlier this year to pass Medicaid expansion, the Commonwealth set a realistic, aggressive timeline for implementation and I’m proud to report the remarkable progress we’re making on these goals in close coordination with our federal partners,” Governor Northam said in a statement announcing Nov. 1 as the date when Virginia will begin accepting applications for expanded health coverage. “I encourage all Virginians to get acquainted with the new eligibility rules and learn how they and their family members qualify for access to quality health coverage.”

Virginia is one of 33 states that have expanded coverage eligibility for low-income adults. The compromise plan in Virginia includes reform provisions on work and personal responsibility so that people who benefit from the program are invested in their own health and success.

Enabling more people to gain health care coverage also means that people will be able to access timely care in an appropriate setting for their needs, so they can recover soon and go about their lives as productive, contributing members of society.

Right now, many people without insurance delay needed medical care for too long. Eventually, they end up in a hospital emergency room when their condition is much worse, the cost of care is much greater, and their recovery time is much longer. That is not an ideal circumstance for the patient, the health care provider, or the economy because that person is removed from the workforce, and the unpaid cost of their care ultimately gets passed on to taxpayers and consumers in the form of higher insurance rates.

Speaking about the new coverage program, Virginia Health and Human Resources Secretary Dr. Dan Carey, MD, noted that “thousands of Virginia adults will soon benefit from a comprehensive package of health services, including coverage for visits to primary and specialty care doctors, hospital stays and prescription medications. Individuals with chronic diseases will have access to the sustained care that is essential to maintain their health.”

This new coverage, Secretary Carey added, will also help Virginians who need behavioral health and addiction treatment as the Commonwealth continues to focus on improving mental health treatment and combating the opioid epidemic.

“This new coverage will help individuals across the Commonwealth like our friends, our neighbors, our caregivers, and the people we meet daily in coffee shops and restaurants,” said Dr. Jennifer Lee, MD, Director of the Virginia Department of Medical Assistance Services. “It’s critically important that hard-working Virginians will have access to the health care they need to be productive in their jobs and to enjoy a high quality of life.

In Emporia and surrounding communities, as many as 3,300 local Virginians will be eligible to enroll in this new health care coverage. This year alone Southern Virginia Regional Medical Center (SVRMC) is on pace to exceed more than $4.3 Million in charity care.

Spencer Feldmann, MD with Southside Physicians Network (SPN) says, “Because of Medicaid Expansion, patients are more likely to get a primary care physician and get their medical needs met earlier before they become too acute.” All SPN physicians accept Medicaid. “In the long run the conversion to a more preventative medicine based approach is a win not only for the patient, but for the Emporia community.

The Nov. 1 start of the application period for coverage enrollment is days away. Virginia adults interested in learning more about this new health care coverage are encouraged to visit www.coverva.org. People can also call 1-855-242-8282 (or 1-888-221-1590 for hearing impaired people) for more information.

After Rally, House OKs Budget Expanding Medicaid


Delegates Mark Levine and Wendy Gooditis pose for a photo with Medicaid expansion supporters on Capitol Hill (Photo credit: George Copeland Jr.)

By George Copeland Jr., Capital News Service

RICHMOND – The House of Delegates passed a state budget that expands Medicaid in Virginia after advocates for the measure held a rally outside the Capitol.

Meeting in special session, the House voted 67-33 in favor of a budget for the 2018-2020 biennium that provides Medicaid coverage to more low-income Virginians. The legislation now moves to the Senate, which during the regular legislative session opposed Medicaid expansion.

Nineteen Republicans joined 48 Democratic delegates in voting for the House version of the budget.

“Our budget expands health care to 400,000 uninsured Virginians, and it increases funding for our schools, creates jobs and gives raises to teachers and law enforcement,” Del. David Toscano of Charlottesville, the House Democratic leader, and Del. Charniele Herring of Alexandria, the chair of the House Democratic Caucus, said in a joint statement.

“We are hopeful that our Republican colleagues in the Senate have seen the light and have heard the chorus of voices in support of expansion.”

House Speaker Kirk Cox, a Republican from Colonial Heights, expressed optimism that delegates and senators can reach an agreement on the budget.

Cox said the House passed “a strong, structurally-balanced two-year state budget that I am confident can serve as the foundation for a bipartisan, bicameral compromise.”

“Virginia has seen extended budget negotiations before, but what sets us apart from Washington is our willingness to work efficiently and directly to adopt a balanced budget before the current fiscal year ends” on June 30, Cox said.

The House vote came after legislators and citizens from across the commonwealth gathered Tuesday afternoon on the Capitol grounds.

Medicaid expansion advocates from Caroline County, Norfolk, Arlington and Charlottesville were joined by Democratic Dels. Mark Levine of Alexandria, Wendy Gooditis of Clarke County and Alfonso Lopez of Arlington.

“I really think our chamber will do what it needs to do, and I have to say, I think some Senate Republicans are coming around,” Levine said.

During the regular session, the House voted 68-32 in favor of a budget that included Medicaid expansion – a priority for Democrats. Expansion would include a Republican-proposed work requirement for those seeking Medicaid coverage.

Democratic Gov. Ralph Northam has expressed his displeasure with the work requirement. (One Democratic delegate, Sam Rasoul of Roanoke, voted against the House budget on Tuesday because of the work requirement.) President Donald Trump signed an executive order earlier this week mandating a similar requirement for food stamp recipients.

Gooditis, who was elected last fall, said her political career was driven in part by her struggle to obtain Medicaid coverage to assist her late brother with post-traumatic stress disorder. She credited the “all-around caregivers” she met during these years for both her election victory and the high spirits she felt going into the special session.

“Keep making noise. It’s how I got here, and it’s how we’ll get it done,” Gooditis said.

Some at the rally are already looking ahead to what policies could follow the proposed Medicaid expansion. They expressed enthusiasm for a single-payer health care system, or “Medicare for All.” Levine said he supports such a system.

“People need to know that these are real people’s lives,” Levine said. “They need to know this isn’t some theoretical question; this is a question of whether people get health care or not.”

Legislators at the rally were critical of the current state of health care coverage in Virginia. While Levine praised the efforts of Doctors Without Borders in providing services in Southwest Virginia and the Northern Neck, he was nonetheless “ashamed” that residents there must rely on an international group that normally serves developing countries.

Lopez discussed the good financial fortune his family had when their newborn baby was delivered prematurely last year, a comfort he stressed wasn’t shared by everyone in his House district. Lopez said the 49th District, which includes parts of Arlington and Fairfax counties, ranks as “one of the most educated” in the U.S. and yet has the “fourth-highest number of people who could benefit” from Medicaid expansion.

“Think about the family that has a baby born prematurely,” Lopez said. “Think about the family that’s struck down by a horrible disease or in a horrific accident. Health care could be devastating for their finances.”

“We’re going to get this done,” Lopez said. “We have to get this done.”

Legislators, Advocates Show Support for Medicaid Expansion

Expanding Medicaid Will Aid Schools, Governor Says

By Sophia Belletti, Capital News Service

RICHMOND – Gov. Ralph Northam and U.S. Sen. Mark Warner are urging the General Assembly to expand Medicaid, saying such a move would free up money to help schools.

On Thursday, the two Democrats sat down with more than 20 teachers, faculty and parents from Richmond Public Schools and surrounding counties to discuss how this would work.

Last week, Northam introduced a new state budget proposal that includes Medicaid expansion and takes a slightly different approach to spending that could shape the debate when lawmakers return for an April 11 special session.

The special session was called because legislators couldn’t reach an agreement on the budget during their regular session. The House of Delegates wants to expand Medicaid, the health-care program for low-income Americans. The Senate opposes that idea.

Because the House’s Medicaid expansion plan would be funded with federal dollars and a new tax on hospitals, budget writers had more money to spend on public education and other services. The Virginia Education Association estimates the House budget allocated $169 million more to K-12 schools than the Senate version.

“We have had the opportunity since January 2014 to expand Medicaid, to give approximately 400,000 working Virginians access to quality and affordable health care,” Northam said at Thursday’s meeting at Albert Hill Middle School. “Morally, it’s the right thing to do in Virginia. No individual, no family, should be one illness away from being financially alive.”

The House version of the budget would increase state aid to $5,617 per student next year and $5,690 in 2020. In the Senate version, state aid per pupil would be $5,583 in fiscal year 2019 and $5,589 in 2020.

“It’s budget time in Virginia, and we, the General Assembly, did work in a bipartisan way,” Northam said. “All of this happened because of folks coming from both sides of the aisle. The most important bill we haven't finished this year is our budget.”

Warner said the commonwealth faces same challenges he encountered as governor in 2002-06.

“Gov. Northam has inherited a challenge that has been around for the last six or seven years,” Warner said. “That is the question of when we talk about education, we also have to talk about health care.”

People at the meeting pointed to numerous funding issues in education, including outdated resources, dilapidated school buildings and overcrowded classrooms. They also said schools don’t have enough full-time staff members such as guidance counselors and nurses,

Northam asked teachers who had full-time nurses at their school to raise their hands. He then asked teachers who did not have full-time nurses. The response was split 50-50.

Rodney Robinson, a social studies teacher at the Virgie Binford Education Center, said the lack of guidance counselors and nurses caused some schools to lose accreditation.

“Instead of just being a teacher, we’re now being a social worker, the counselor,” Robinson said. “If we can get those (guidance counselors and nurses) back in the school systems, I can guarantee you’ll see more teachers in those harder-staffed schools because there is less work burden on them.”

Melinda Lawson, an eighth-grade English teacher at Albert Hill, echoed Robinson’s frustration.

“For Richmond, we have a very difficult time creating 21st-century learners when we don’t have the resources to do so,” Lawson said. “I’ve been in this building for 14 years, and I’ve worn many hats in this time. We’re always trying to get there, and everyone else seems to be where we’re not, and we’re aspiring to get there.”

Northam said “providing a world-class education” is a priority for his administration.

“There is power in every child, and we need to make sure every child in Virginia reaches their maximum potential,” he said.

Citizen Groups Voice Concerns Over Medicaid Expansion

By Ryan Persaud, Capital News Service

RICHMOND – A few days after the Republican-controlled House of Delegates reached a bipartisan compromise on Medicaid expansion, both conservative and progressive citizen groups are voicing their concerns.

The proposal, HB 338, would require “able-bodied adult” individuals seeking Medicaid to fulfill a work requirement – to pursue training, employment, education, or “other community engagement opportunities” – in order to obtain health care coverage. The work requirement would not apply to children, or to adults who are over 65, have certain disabilities or are the primary caregiver for a dependent.

The Family Foundation, a Richmond-based grassroots conservative organization, urged residents in a blog post on Tuesday to contact their delegates and voice their opposition to the notion of expanding Medicaid.

“After eight years of holding the line and refusing to ‘take the bait’ for a massive federal power grab, corresponding spikes in healthcare costs, and virtually guaranteed new tax liabilities for hardworking Virginians, the House plan would now capitulate to the specious promise of ‘free money’ from the federal government to pay for healthcare,” the post said.

The organization acknowledged that more Virginians will receive care under the plan but argued that it would come at a cost to taxpayers. “While tax increases may not be immediate, they are inevitable if this policy goes through,” the post said.

Progress Virginia, a liberal advocacy organization, also spoke out against the proposal, but for different reasons. It argued that while the House plan to expand Medicaid is a step in the right direction, the work requirement is a cause for concern.

“From the outset, we have opposed attempts to put punitive barriers between Virginians and access to care,” the organization stated in a press release on Sunday. “We have serious reservations about language in the House budget that puts financial restrictions on families’ access to care, premises access to care on the ability to find a good-paying job, or locks our friends and neighbors out of access.”

In a blog post, Progress Virginia argued that work requirements are ineffective and ultimately make health care harder to obtain. The organization also urged progressives to contact their delegates in support of a “clean Medicaid expansion” – Medicaid expansion without the work requirement.

“People have to be healthy in order to work, but that isn’t possible when they don’t have health insurance and can’t see a doctor when they need to,” Progress Virginia said. “Work requirements don’t create jobs or raise wages – they put onerous and punitive requirements between our friends and neighbors and the healthcare they need.”

Gov. Ralph Northam said that while he supports a more “straightforward” expansion of Medicaid, he is willing to compromise with Republicans.

“I respect the priorities of the House majority and I am encouraged by and supportive of our work together to bring about a new ‘Virginia Way’ on Medicaid,” Northam said in a statement on Sunday.

“I look forward to working with the House and Senate to finalize this proposal, ensure its passage and pursue an implementation plan that will provide the benefits of expanded coverage to Virginia families.”

Senate Republicans Reject Medicaid Expansion

By Chris Wood, Capital News Service

RICHMOND – Republicans in the Virginia Senate on Thursday tabled legislation that would have expanded Medicaid coverage to hundreds of thousands of lower-income residents of Virginia.

Voting along party lines, the Senate Education and Health Committee indefinitely postponed action on the proposal. The eight Republicans on the panel voted to kill the measure; the seven Democrats voted to keep it alive.

The federal Affordable Care Act encouraged states to expand Medicaid. Democratic Sen. Richard Saslaw of Fairfax noted that Virginia’s neighboring states – including West Virginia, Tennessee and Kentucky – have done so.

Saslaw said the federal government has promised to pay most of the costs of Medicaid expansion.

“If someone came up to me and said, ‘Saslaw, we’ll pick up 90 percent of your medical insurance costs if you pay the other 10, and we think we have a way around that 10,’ I would have to be a lunatic to turn down that offer,” Saslaw said.

However, Republican senators said they fear that Medicaid expansion would put a hole in the state budget.

“The federal level, they can just raise the debt ceiling,” said Sen. Amanda Chase of Chesterfield County. “We can’t do that at the state level.”

She said the state has limited resources. As Medicaid takes up more of the state budget, others services would have to be cut back, Chase said.

“It doesn’t take long to see we have major infrastructure needs,” Chase said. “We have bridges in my district that you can’t even drive ambulances over or fire trucks over because of the crumbling infrastructure.”

A fellow Republican, Sen. Richard Black of Loudoun County, said Medicaid costs are escalating out of control.

“I think it’s premature to move forward on this and potentially get ourselves stuck in a situation where we’ve expanded, and all of a sudden we’re having to do this thing on our own dime,” Black said.

The legislation at hand was SB 572, sponsored by Republican Sen. Emmett Hanger of Augusta County. A similar measure – SB 158, filed by Sen. John Edwards, D-Roanoke – had been folded into Hanger’s bill.

Democrats, including newly elected Gov. Ralph Northam, have made Medicaid expansion a top priority. It was also a priority for many of the people who attended Thursday’s committee meeting. They included Julien Parley, who has a son with autism. She said Medicaid expansion would help mothers like her.

“There was a time that I worked three jobs, and I couldn’t afford to go to the doctor,” Parley said. “I resorted to going to the emergency room, which racked up bills and it also was a hardship on my credit.”

People without health coverage often resort to the emergency room, said Julie Dime of the Virginia Hospital and Healthcare Association.

“Countless Virginians that don’t have access to health care find their only option to be the hospital emergency room,” Dime said.

Editorial - Why don't we Expand Medicaid?

In the Capital News Service article above this Editorial, Republicans in a Senate Committee killed Medicaid Expansion. It is no surprise that this has happened - it has happened in each of the four years that I have been publishing Emporia News.

This year one of the bills to Expand medicaid was offered by a Republican, and the committee still killed it. Also this year one Republican, Senator Amanda Chase (R-Chesterfield) cited the need to repair our crumbling infrastructure. Our infrastructure does need work. We have a great many rural communities that have insufficient Broadband Access; we have roads and bridges that need repaired; All interstate highways in the Commonwealth could use a few more lanes in places; Exit 11 is horrible, and needs to be colmpetely reworked to include acceleration and deceleration lanes (lets face it, getting from I-95 south to US58 East is sometimes a quite harrowing experience). With all of these needs, seemingly no major bills or budget amendments have deen offered. Infrastructure is a bit of an arbatrary term when speaking of legislation, but a quick glance at the LIS website shows no major bills of budget amendments for Transportation and the only place where Broadband Communications Infrastructure is mentioned seems to be a bill about how to mark highways during construction of those projects. Even with as random as the term infrastructure is, none of the bills where Senator Chase is listed as Chief Patron or Co-patron will have any impact on crumbling infrastructure.

Here is the impact of Medicaid Expansion in Colorado, my home state: "A new report examining the economic and budgetary impact of Medicaid expansion in Colorado reveals that, in the two years since implementation, expansion in the state has had a significant positive effect on the economy at no expense to the General Fund. According to the preliminary independent analysis, 'Assessing the Economic and Budgetary Impact of Medicaid Expansion in Colorado: FY 2015-16 through FY 2034-35,' Colorado has added 31,074 jobs, increased economic activity by $3.8 billion and raised annual household earnings by $643 due to the state Medicaid expansion under the Affordable Care Act. By fiscal year (FY) 2034-2035, Colorado is projected to add a total of 43,018 new jobs, increase economic activity by $8.5 billion and raise average annual household earnings by $1,033."

The Affordable Care Act included the funding to expand Medicaid, and by not accepting that funding, the hard-earned money of Virginia Taxpayers is being used to fund Medicaid Expansion in all the other states that have expanded their program.  Virginians gave states like New York 5 MILLION DOLLARS EACH DAY ($2,839,000,000 - that is Two Billion, Eight-Hundred Thirty-Nine Million Dollars) in the first year alone. Those losses in tax dollars are in addition to the lost economic activity mentioned in the preceding paragraph.

Expanding Medicaid in Virginia, which the Federal Government would pay for (100% now, 90% after 2020), would bring that money back to the Commonwealth, help rural hospitals and help poor families live better lives. Expanding Medicaid is the only Fiscally Responsible - the only Fiscally Conservative - option available to the General Assembly.

Don't read too much into my opinion here. I am not calling for completely re-inventing our current system, I am not saying that we need our own National Health Service like the one in the United Kingdom. All I am saying in this Editorial is that medicaid Expansion would be good for the Virginia Economy. By providing care via Medicaid we are, not only, helping our friends and neighbors get the care that many of them need but helping the Economy. Virginia has a larger population than Colorado (by about 3 Million people), so we stand to benefit even more than Colorado.  Even if there were only 100-150 jobs created in Emporia-Greensville and our economy were to expand by $10-15 Million, our community would be better off with Medicaid Expansion.

At a Town Hall Meeting here in Emporia, hosted by Senator Louise Lucas, a representative from Southampton Memorial Hospital, whose parent company also owns SVRMC, said that Medicaid Expansion would be a good thing for hospitals like SVRMC and that every hospital in the Commonwealth was in favor of Medicaid Expansion. At that August, 2014, meeting it was said that CHS would lose $1.7 Million over two years between Southampton Memorial and Southside Virginia RMC and would most likely see cuts in staffing and services - both of which we are seeing now. Monies that the Federal Government used to Expand Medicaid came from other indigent care programs. Without Expanding Medicaid, hospitals now absorb the cost of that indigent care, raising the cost of care for everyone else in the community, cut back services like birthing centers and surgical care - even sending patients to other hospitals for those services, or close up completely for lack of positive cash flow.

Expanding Medicaid would help more people than you think. In the spirit of full disclosure, I would, most likely) be one of them, as would anyone that makes less than $16,000 each year. Medicaid Expansion would help the "working poor" like those Restarurant Servers (who make $2.13 per hour, plus tips). Perhaps that fear the Republicans have, that feeling that the Federal Government would renege and suddenly stop paying for Medicaid stems from the fact that Republicans in the General Assembly did just that to every locality with a State Prison. The General Assembly agreed to a program called "Payment in Lieu of Taxes" to help those localities that lost parts of their property tax base (since the Commonwealth of Virginia does not pay Real Property Tax); The Republicans in the General Assembly broke their word to those communities (including Greensville County, Southampton County, Sussex County, Brunswick County, Nottoway County and Mecklenburg County) and stopped making those "Payments in Lieu of Taxes" after only one year.

Health Secretary Urges Medicaid Expansion

By Margo Maier, Capital News Service

RICHMOND – Virginia’s secretary of health and human services, William A. Hazel, wants legislators to put aside their political differences and ensure that every resident of the commonwealth has access to affordable health care.

Hazel is urging the General Assembly to expand Medicaid, the health coverage program for low-income people, as states are encouraged to do under the federal Affordable Care Act. Hazel made his case again in a recent talk to students at Virginia Commonwealth University Medical Center.

Although the Affordable Care Act made it easier and cheaper for many people to buy health insurance, Hazel said coverage gaps still exist.

“We had about 1 million Virginians who were uninsured in 2010,” he said. “Probably two-thirds of the people who came to a community health center last year to try and get coverage were told, ‘You do not qualify for a benefit in an exchange because you do not make enough money.’ Also, we do not cover single adults. We have all these people at lower incomes who are not eligible.”

That’s why Gov. Terry McAuliffe and other Democrats are pushing for the state to offer Medicaid to about 400,000 more Virginians. Under the Affordable Care Act, states can extend Medicaid to people with incomes up to 133 percent of the federal poverty level. The federal government has promised to pick up most of the cost, which would be about $2 billion annually for Virginia.

“Last year, we made a big effort to get Medicaid expanded ... I think the political odds are this year that the House Republicans will not change their position, but I think this is something that we can do,” said Hazel, who was appointed by Republican Gov. Bob McDonnell and reappointed by McAuliffe.

Republican legislators in Virginia oppose Medicaid expansion because the program’s costs have been growing and they fear the state eventually will be stuck with the bills. Republicans blocked several efforts by Democrats in the General Assembly to expand Medicaid in 2014.

Hazel spoke at the VCU Medical Center, just blocks from the state Capitol, as the General Assembly’s 2015 session got underway.

He told students that 18 percent of the U.S. gross domestic product goes toward health care – more than in any other nation. Switzerland has a universal health care system, and only 11.5 percent of its GDP in 2012 was spent on health care.

“How can we justify spending so much more money than Switzerland?” Hazel asked. “They are spending two-thirds of what we are spending, and we have people who are not cared for. I’m asking how that happens.”

Much of the problem, he said, is that many Americans lack health coverage and forgo preventive medical care, such as physical exams and screenings. When they have a dire need, they go to hospital emergency rooms, which must treat everyone regardless of insurance status.

Hazel, an orthopedic surgeon, said he wants to change that: “We’re trying to go from ‘fix it when it’s broken’ – which has been my life’s work – to find out how to invest in healthier people who can be more productive.”

McAuliffe has asked the General Assembly to consider expanding Medicaid when it revises the state budget during the legislative session, which runs through Feb. 28. Republican lawmakers so far have rebuffed that request.

Other Medicaid-related proposals before the assembly include:

·         HJ 520, a constitutional amendment sponsored by Del. Patrick A. Hope, D-Arlington. It would exempt nonprofits serving indigent people from paying property tax.

·         HJ 637, by Del. R. Steven Landes, R-Verona. It would authorize a study on how to reduce Medicaid costs and improve patient services. A House subcommittee approved the resolution last week.

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.

CITY OF EMPORIA TOWN HALL MEETING ON MEDICAID EXPANSION *TONIGHT*

Senator L. Louise Lucas will be hosting a Town Hall Meeting to discuss Governor Terry McAuliffe’s Medicaid Expansion Plan for the Commonwealth of Virginia. The Meeting will be held on Thursday, August 7, 2014 at 6:30 PM at the City of Emporia Council Chambers located at 201 South Main Street, Emporia Virginia 23847.

Dr. Jennifer Lee, Deputy Secretary of Health & Human Resources for Virginia, Gaylene Kanoyton, President of Celebrate Healthcare and Steve Ramey, Chief Financial Officer from Southampton Memorial Hospital are confirmed presenters. Members of the General Assembly invited to join Senator Lucas are Senator Frank M. Ruff, Jr., Senator John A. Cosgrove, Jr., Delegate Roslyn C. Tyler and Delegate Richard L. Morris.

Currently there are an estimated 400,000 Virginians in the "Coverage Gap."  Those Virginians include Veterans, Working Parents and the Working Poor; people who make too  little money to afford coverage on the Marketplace.  The Commonwealth Department of Finance estimates that the cost of expanding Medicaid would be $127 Million; and while they also warn that that estimate could be on the low end, the truth is that the Federal Government will be paying 100 percent of the cost for three years and at least 90 percent after that. 

Accepting funding for the expansion of Medicaid allows the tax dollars collected from hard working Virginia families to be put to work helping the People of the Commonwealth.  These funds have already been collected, and the only way they will come back to Virginia is by expanding Medicaid.  The Commonwealth looses $4.4 Million every day that Medicaid is not expanded.  To date we have already lost $920 Million, amid partisan bickering in Richmond.  Conservatives in both the Virginia Senate and the House of Delegates have resorted to extraordinary measures to punish Veterans and the Working Poor for being, well, poor.   The only financially responsible option is to accept this funding and expand Medicaid.

McAuliffe Proposes Fed Funded Medicaid Program

 

By Eric Luther, Capital News Service

RICHMOND -- Gov. Terry McAuliffe addressed critics of Medicaid expansion as part of Virginia’s biennial budget by proposing a two-year pilot program he says would close the commonwealth’s healthcare gap without financial penalty to the state.

McAuliffe’s 45-minute address signified the beginning of the General Assembly’s special session, which was scheduled in effort to reach an agreement on the roughly $96 billion two-year budget currently at odds over expanding Medicaid coverage to more than 400,000 currently uninsured Virginians.

McAuliffe says the federally funded pilot program would allow Virginia to once again “lead the way” by helping its sickest citizens gain access to healthcare, keep hospitals and clinics afloat, and bring taxpayer dollars back to the commonwealth.  “Opponents have thrown up road block after road block,” McAuliffe said in the Monday address on Capitol Square. “But their arguments have been overcome by simple facts.”

Detractors said closing the healthcare coverage gap would cost Virginia millions of dollars. However, according to McAuliffe, expanding Medicaid would in fact save Virginia’s state budget more than $1 billion between now and 2022.

The proposed pilot program is backed by a letter from the Centers for Medicare and Medicaid Services and states if Virginia implements an expansion of Medicaid coverage for two years, and then drops such coverage at the end of that time period, there would be no financial drawback and no reduction in federal dollars otherwise available to Virginia for its Medicaid program.

The letter is significant, McAuliffe says, because it opens the door for a pragmatic and balanced approach to closing the healthcare coverage gap that all sides should find reasonable.  “There can be no more excuses,” McAuliffe said. “Hundreds of thousands of working families throughout Virginia are counting on us to set aside partisan politics and get the job done.”

McAuliffe harked back to the days of former Gov. Bob McDonnell to further the notion of setting aside partisan disagreements, and urged delegates and senators alike to reach a compromise in the coming weeks.  “Gov. McDonnell included funding in his budget for the Affordable Care Act as early as 2012,” McAuliffe said. “And please let us not forget that the Medicaid Innovation Reform Commission itself was a creature of the budget.”

In addition to Medicaid expansion, McAuliffe highlighted some of the other elements of his biennial budget, including $1.8 million for mental health initiatives, $4.8 million for extended school year grants and $17 million to fund the Line of Duty Act with the Virginia Retirement System.

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