By John Edwards
Edwards represents the 21st District in the Virginia Senate, which covers Roanoke, Giles County, and parts of Montgomery and Roanoke counties. He is a Democrat.
Following five years of partisan opposition, Medicaid Expansion was approved by the Virginia General Assembly in an extended session in 2018, as a result of the Blue Wave election of 2017 and a few courageous Republicans crossing party lines.
The new benefits starting Jan. 1, 2019, provide essential healthcare for thousands of uninsured low income Virginians. Some 300,000 newly enrolled citizens now receive services as of July 26, 2019. The Department of Medical Assistance Services (DMAS) projects 360,000 to be enrolled by year-end and 375,000 enrolled by mid-2020, of the over 400,000 believed to be eligible.
In my Senate district in the Roanoke and New River Valleys, more than 12,000 citizens are now enrolled in Medicaid expansion: 6,252 in Roanoke City, 3,128 in Roanoke County, 2,586 in Montgomery County and 765 in Giles County. These newly enrolled citizens, not previously eligible for Medicaid and financially unable to afford private health insurance, had no primary healthcare provider to see for preventive, chronic and acute healthcare needs.
While traditional Medicaid covers only children, mothers and pregnant women, Medicaid expansion covers adults over 18 years. Eligibility for expansion coverage includes adults earning up to 138 percent of the federal poverty level, which is $17,237 annually for a single adult and $29,436 for a family of three.
Had Medicaid expansion been approved when first available, January 1, 2014, Virginia’s economy would have received at least $ 1.7 billion in each of the last five years from federal dollars we have been sending to Washington for this purpose. In addition, Virginia taxpayers would have saved hundreds of millions of dollars spent on indigent, mental health and inmate healthcare which is replaced by Medicaid expansion funds.
Medicaid expansion now covers 36 states and the District of Columbia and some 12.3 million Americans. The holdout states are led by Republicans who say they worry about the growth of Medicaid costs in their states. They ignore the federal dollar benefits and that the federal government pays 100 percent of the costs of expansion through 2020, and thereafter 90 percent of the costs, unlike the 50-50 split of traditional Medicaid which covers children, mothers and pregnant women.
Most people helped by Medicaid expansion live in poorer and more rural, and often more Republican, areas.
According to Virginia Consumer Healthcare Experience State Survey, Southwest Virginia residents are the least able to afford healthcare in the state; studies show that 63% of these residents cannot afford private health insurance, delay or forego healthcare, or struggle to pay medical bills.
Yet, these lower income Virginians often need healthcare services the most. According to Dr. Jennifer S. Lee, Director of DMAS, the new 2019 enrollees show significant healthcare needs which are often complex in nature. Nearly 35,000 have a history of hypertension, more than 16,000 have a diabetes diagnosis, more than 15,000 have a history of substance abuse, and about 2,500 have cancer. These ailments along with mental health issues are just a few of the many health dilemmas the poor in Virginia suffer from.
People benefiting from Medicaid expansion are also pleased with their coverage. According to the Kaiser Foundation, people in focus groups in states with Medicaid expansion in 2017 were highly satisfied with their Medicaid expansion coverage. Interestingly, most did not realize that their insurance was a result of the Affordable Care Act.
The new federal revenue from Medicaid expansion is helping to better manage patient care for more people, head off further health complications, and improve the lives of many Virginia families. The new revenue also ripples through the economy resulting in creating more jobs and more tax revenue to the Commonwealth.
Medicaid expansion is a win-win across the board; for those hundreds of thousands of Virginians who would not otherwise be served, for hospitals and health care facilities who serve the uninsured without compensation, and for businesses and private insurers who pay indirectly the costs shifted to cover uncompensated care.
Virginia benefits when all citizens have healthcare coverage. It improves our economy and it enhances our society as one of fairness and basic justice.