McDonnell wants ‘dramatic’ cost-saving reforms to expand Medicaid in Virginia
The governor does not support expansion, and has a list of changes he said must be considered.
This is part of a series of occasional stories examining how the Affordable Care Act — widely called Obamacare first by critics and now also by some supporters — will change how you access and pay for health care. The series will look at the impact the new law has on individuals, businesses and health care providers in Southwest Virginia.
- Read the first story in the series: Virginia still undecided on Medicaid expansion
- Listen to reporter Laurence Hammack talk about the series with WVTF's Beverly Amsler.
Sunday, June 16, 2013
If Medicaid is expanded in Virginia, it will only be after major changes are made to what some call a cumbersome and inefficient system.
“The federal mandates, regulations, taxes and spending create an expensive, top-down, bureaucratic system,” Gov. Bob McDonnell wrote in a March 5 letter to U.S. Health and Human Services Secretary Kathleen Sebelius.
McDonnell made it clear that he does not support an expansion, and that the state will not even consider one unless there are “dramatic, verifiable cost-saving reforms of the program.”
A legislative commission, which meets for the first time Monday, has been charged with determining whether those goals have been met. A vote by the panel could come by year’s end.
Here are some of the needed reforms that the governor listed in his letter:
- Make the government insurance program for the poor and disabled work more like a commercial plan, in part through a managed care delivery system. That could include requiring recipients to make co-payments, and cutting benefits such as transportation to a doctor’s office or clinic for nonemergency care.
- Establish provisions to reduce the financial burden that Virginia carries in the federal-state system. That could include getting a promise from Washington to fund 90 percent of the expansion’s cost beyond 2022, and assurances that doing that would not increase the national debt.
- Maximize tools currently available in Virginia, including waivers to streamline the administration of primary, acute, behavioral health and long-term care services.
- Allow the state to require Medicaid beneficiaries to participate in wellness programs and preventive medicine, such as getting an annual physical.
Obtain buy-in from health care stakeholders for a strategic plan to reduce the cost of all medical, behavioral health and long-term care services statewide, which in turn would reduce Medicaid expenses.
One of the demands — to launch a managed-care style pilot program to coordinate care for people eligible for both Medicare and Medicaid — has already been met.
While there are plenty of critics of Medicaid expansion and the larger Affordable Care Act that launched the concept, supporters say the key mission of providing better and cheaper health care should prevail.
“Regardless of your politics, it is the law,” said Nancy Agee, president and CEO of Carilion Clinic.
“I’ve been spending a lot of time on the road to Richmond to help our legislators understand the importance of expanding Medicaid,” she said — both from the perspective of providers like Carilion and the patients they serve.
“Having access to insurance will help us be a more healthy community,” Agee said.
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THE ROANOKE TIMES
