If reforms are achieved, Virginia would be foolish to refuse

The Affordable Care Act is a complicated attempt to create a system whereby all individuals, regardless of income, have access to some form of affordable health insurance. Hundreds of millions of dollars have been spent on political ads characterizing “Obamacare” as either wonderful or terrible, and yet the ads were not intended to inform us of the pertinent facts so we could understand and draw our own conclusions.

As a result, the emphasis has been on President Obama and not on the fact that we need to provide affordable access to health care. We have a great health care system in Virginia and throughout our country. The problem, of course, is that many cannot afford it, and the costs for health care treatment and insurance are rising on an unsustainable course.

Should we expand Medicaid in Virginia? I have been, and still am, reluctant to say yes. But I am certainly now convinced that we have an opportunity to use this issue as a wedge, of sorts, to force significant reforms that will not only make Medicaid better, but also can be a part of a broader effort to bend the health care cost curve down. We are in a unique position now to negotiate with the federal government to tailor a Medicaid program that is cost effective and responsive to the needs of Virginians.

I was a part of establishing a process to push for a series of verifiable reforms in our Medicaid program. If these reforms are achieved, then it would be foolish for Virginia not to utilize an existing dedicated appropriation of federal money to expand Medicaid coverage. We have the opportunity to better control health care costs; reduce the pressure for increases in commercial health insurance; improve Medicare; stabilize the tenuous fiscal condition of our hospitals (particularly in rural areas); provide better value for our tax dollars; and most importantly, provide access to a better quality of care for Virginians.

Our current system, without reforms, has left us with ever-increasing budgets, inadequately compensated physicians and facilities, and a lack of money for pressing needs, such as funding to provide care for individuals with intellectual and developmental disabilities who are currently on a large and growing waiting list.

Doing nothing is not an appropriate option. Without reforms, we should not expand Medicaid. We need, however, to achieve significant reforms, and this is our challenge. We, as policymakers, will have failed those we represent if we do not identify problems in the system and implement significant reforms. This should allow us to cost-effectively expand health care access to those who truly are in need. Once we achieve objective reforms and appropriate waivers from the federal government, then using federal money to expand access to health care as anticipated under the Affordable Care Act will seem prudent.

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