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More than 100 speakers voiced their opinions at a packed General Assembly hearing room.
Wednesday, October 16, 2013
RICHMOND — The first speaker went straight to the bottom line of whether the state should expand its Medicaid program to hundreds of thousands of uninsured Virginians.
“This is our money,” said John Shinholser, president and co-founder of the McShin Foundation in Henrico County. “Let’s bring it back to Virginia.”
With Virginians expected to pay an additional $26 billion in taxes over the next 10 years under the Affordable Care Act, Shinholser wants the state to accept more than $23 billion in federal funds to expand Medicaid and help pay for the drug and alcohol recovery programs his foundation runs.
His view — the first of 103 speeches delivered to the Medicaid Innovation and Reform Commission in a marathon five-hour public hearing Tuesday — was not embraced by all in an audience that packed a General Assembly hearing room and spilled into another room.
Hundreds of green-shirted members of Americans for Prosperity provided visible and vocal opposition to possible expansion of Virginia’s Medicaid program, which they and other opponents argued will never get all of the money the federal government has promised under the law championed by President Barack Obama.
“I no longer have faith that the federal government of this great country will fund Medicaid expansion for the long haul,” said Nancy Smith, a retired audiologist with the Henrico school system who was one of several speakers to voice fears that an expanded Medicaid program would compete with state aid for education.
But supporters outnumbered opponents by about 3-to-1 at the hearing, as well as in more than 1,400 online written comments received by the commission, according to counts by health insurance and hospital advocates who favor expansion.
The gulf between supporters and opponents also was wide on whether expanding Medicaid would help the estimated 400,000 uninsured Virginians it is intended to help.
Dave Schwartz, an Arlington County resident and state director of Americans for Prosperity, showed a picture of his daughter and said he would not risk his family’s future by relying on Medicaid care.
“Coverage means nothing if you don’t have care,” Schwartz said.
But expansion of Medicaid was urged by officials for the hospitals, physicians, community health centers and mental health providers that form a safety net that depends on government and insurance premiums subsidies to pay for care of the uninsured.
Sheryl Garland, vice president of health policy and community relations at Virginia Commonwealth University Health System, said more than 60 percent of the visits by uninsured patients in the Richmond hospital’s emergency rooms are “avoidable” — if they have a way to pay for primary and preventive care.
But not all doctors favor Medicaid expansion.
Dr. Caroline Triepel, a Virginia Beach orthopedic surgeon, spoke against expansion and advocated “free market solutions” to health system problems.
Virginia health insurers also made a big show of support for expansion, which they said could be accomplished through private health plans that already serve more than 700,000 Medicaid recipients in the state through managed care.
“We have the commercial networks today to serve the expansion population,” said Doug Gray, executive director of the Virginia Association of Health Plans.
All 10 legislators and two Cabinet secretaries on the commission attended the public hearing and almost all of them stayed to the end. They will meet again Monday as part of a bimonthly schedule to oversee three phases of Medicaid reforms required under a budget compromise this year before the state could expand the program as early as July 1.
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