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Division Over Medicaid Overhaul

The General Assembly panel tasked with deciding whether Virginia should expand its Medicaid program or not held its first meeting–in a room packed with expansion opponents, many representing groups such as Americans for Prosperity.

The Senators and Delegates wasted no time getting up to speed on the complex facts about how the program currently operates.

Nearly 20 percent of Americans are now covered by Medicaid, including 41 percent of all births.  Federal law mandates ten services, such as hospitalization and non-emergency transportation. Virginia provides other optional services, such as dental care, to children.  But Delegate and Dr. John O’Bannon said some of the federal rules just don’t work.

“These are all federal obligations that take from us flexibility. And the best example is the podiatry because you either offer podiatric services to EVERY person getting Medicaid—or none," said Dr. O'Bannon.

But he said some will lose limbs without this care.  Secretary of Health Dr. William Hazel said costs range each year from an average of $2900 per child to $5600 per adult, and even more for those in long-term care.

“And these folks are costing about $48,000 per person per year.”

Virginia has 980,000 enrollees, and the expansion would add at least a quarter of a million adults. 65-million claims are made annually, making it the fast-growing item in the state budget. 

The federal government has said it will cover all costs of new enrollees under the Medicaid expansion for three years, and 90 percent of costs after that.