Virginia’s Medicaid program provides healthcare for poor children, the elderly and disabled, but working adults rarely qualify. Experts say as many as 400,000 people could get insurance if the state were to expand its Medicaid program, but there’s another reason why some lawmakers support that idea – it could be good for the economy.
Opponents say Virginia can’t afford to expand Medicaid - even with the federal government paying 90-100% of the bill, but supporters say failing to expand the program will be even more expensive.
Michael Cassidy heads the Commonwealth Institute for Fiscal Analysis.
“We’ve seen a dramatic shift in our economy over the last 30 or 40 years where fewer and fewer jobs in Virginia come with healthcare.”
More than 100,000 Virginians in tourism, retail, education, construction and healthcare itself don’t get insurance through their jobs. If they get sick and can’t work, they don’t pay taxes, and they often end up in hospital emergency departments where the law requires care be provided.
Kathleen Heatwole is with Augusta Health in Fishersville.
“Twenty to 22% of all the ED visits fall into that uncompensated care. Our psychiatric unit is another area where we have such a large percentage of patients with no insurance coverage at all.”
The hospital eats some of the costs and charges insured patients and people who can pay out of pocket even more to make ends meet, but things are about to get worse for hospitals like Augusta. In 2015, the federal government will start paying them less for services provided to senior citizens on Medicare.
That could be a problem for all of Augusta County. Heatwole says 2,000 people work at the medical center, making it the area’s largest employer.
“We are one of the economic engines for the community. In fact, the economic development directors come to us as they’re bringing new industry into the area, because one of the main criteria that an industry that wants to relocate looks at-- they want to know what are the schools like, and what is the hospital like.”
And Augusta is not alone. Statewide, one in ten working Virginians has a job in the healthcare sector. That’s why supporters like Delegate Sam Rasoul of Roanoke say expanding Medicaid would be a good thing. He and fellow Democrat Patrick Hope have come up with a bill to make more people eligible. It includes restrictions to please conservatives who think everyone should pay something for medical care, and all able-bodied people should be employed or looking for work.
“There are co-pays and deductibles and work search requirements. Every conservative principle that we can find across the country have been integrated into the Healthy Transitions Medicaid Expansion Program.”
Last week that measure was tabled, but Rasoul is pinning his hopes on 2016, when moderate Republicans won’t be facing tea-party challengers who oppose all aspects of Obamacare. The hospital association’s Chris Bailey says Rasoul’s timing might be right.
“You’d be hard pressed to find anybody who’s optimistic about solving the Medicaid issue this session, but we’re in it for the long term, and this issue has to be resolved.”
In the mean time, Republican Delegate Steve Landes predicts lawmakers will come up with some money for the state’s ailing hospitals and patients.
“We are looking at ways to bolster the health safety net either through free clinics or rural hospitals and community health centers, so that is something I think you’ll see movement on - both the house and senate -- to try to bolster that to cover more people, protect more people, and I think that’s reasonable.”
So far, only one lawmaker has proposed providing more money to Virginia’s medical safety net - free clinics and community health centers. Senator Bill Stanley of Martinsville offered a budget amendment of $1.5 million. Virginia hospitals provide $600 million in charity care each year.
