By Chris Hurst
Hurst represents Giles County, Radford, and parts of Montgomery and Pulaski counties in the House of Delegates. He is a Democrat.
300,000 is undoubtedly a large number. It roughly represents the number of Hokies crowding the stands at five sold-out games in Lane Stadium. In population terms, it is approximately the size of the entire Roanoke metropolitan area and more than three times the number of residents living in the New River Valley’s 12th District, which I represent in the House of Delegates.
300,000 also represents the estimated number of working Virginians who will gain access to health insurance in the budget passed by the House of Delegates last month. In a decisive and bipartisan vote, the House expanded Medicaid coverage under the Affordable Care Act to Virginians earning up to 138 percent of the federal poverty line, a truly historic advance in the delivery of health care in the Commonwealth. House Democrats fulfilled a key promise to the voters who spoke so loudly last November, striking a reasonable compromise with our Republican colleagues to achieve this priority goal. However, the Senate budget failed to include provisions to expand Medicaid coverage, leading Gov. Northam to call a special legislative session on April 11 for the two chambers to negotiate a final budget agreement. Each chamber will meet again on Tuesday to potentially vote on a new version of its budget before negotiations between the House and Senate begin in earnest again.
When a complex legislative policy impacts such an enormous number of people, it is easy for human stories to become lost in a statistic—after all, it is difficult to picture exactly what 300,000 people represents. As politicians, pundits, and the press crunch the numbers, though, we too frequently lose sight of the most important factor in the debate—the faces of the Virginians directly impacted by the expansion of Medicaid coverage.
During last year’s campaign, I saw these faces daily and heard their stories firsthand. In Blacksburg, I met Judy Ruggles, who hasn’t been able to afford insurance since her husband died. In Radford, I listened to Jackie Jackson, who, even with ACA subsidies, can’t pay the high premiums she found on the health care exchange. In their stories, as well as countless others, I saw citizens in Southwest Virginia who were working hard to make ends meet, yet were one diagnosis away from financial disaster. Across the Commonwealth, my colleagues in the House heard similar stories as they knocked on doors throughout their districts. The conclusion was clear—the General Assembly had a moral responsibility to expand quality health coverage to Virginia’s most vulnerable citizens.
During each of these conversations, we listened closely. We listened when the collective voice of Virginians spoke emphatically at the polls in November. And we listened to the countless citizens who brought their powerful advocacy to the State Capitol when the General Assembly convened in Richmond earlier this year.
There are numerous arguments in support of Medicaid expansion, all of them convincing. To date, Virginia has lost more than $10.5 billion in federal tax revenue—well over $5 million every day—by failing to expand Medicaid coverage. The House plan will return Virginians’ tax dollars to the Commonwealth, creating hundreds of millions in savings to invest in K-12 and higher education, law enforcement, and other critical public services. Additionally, individual taxpayers will not be responsible for the state’s share of expansion costs, as the House budget introduces a provider assessment on hospital revenues to cover the ten percent of costs not funded by the federal government.
With the Affordable Care Act here to stay, the House plan to expand Medicaid is fiscally sound and simply makes economic sense. Across the Commonwealth, Virginians agree: over 80 percent support expansion. And 32 states, a majority of them Republican-led, have already enacted.
While the numbers alone are compelling, they cannot fully capture the significance or urgency of this issue. We have an opportunity to ensure that more than 300,000 of our most vulnerable citizens gain health coverage for the first time, through a policy framework that actually creates substantial new revenue for the Commonwealth. With the faces of just a few of those Virginians in mind, the correct decision—the moral decision—is incredibly clear.
As we prepare to return to Richmond for the special session, I will be thinking of those faces as the General Assembly negotiates a final budget agreement. I hope that my colleagues in the Senate will do the same.