Health Insurance

Lawmakers in Richmond today heard a report… saying Virginia is likely spending millions in state-funded healthcare for people who don't actually qualify for the benefits.

There’s no specific number for how much Virginia is spending on Medicaid that it shouldn’t… but there is an estimate for one aspect of the program that can give officials a sense.

To be eligible for Medicaid you have to re-apply every year… and there’s a huge backlog of those applications.

It’s the time of year to sign up for health care. This year is the third that Virginians can shop around for policies through the Affordable Care Act -- or ObamaCare -- marketplace.

The question now is how many people will sign up again this year. Last year, 34-percent of those eligible for health-care through the marketplace participated. A number on par with the national average, says Massey Whorley, a healthcare policy analyst at The Commonwealth Institute, a liberal-leaning think tank in Richmond.

Virginia is one of 19 states that have not expanded Medicaid under the Affordable Care Act.  So community clinics here are expanding their mission and changing their image as they strive to fill the gap. 

There’s a misperception that what used to be called Free Health Clinics still serve only adults who can’t afford to pay… that people fortunate enough to have health insurance, should never patronize.  But in fact, the opposite is true.

“Now we see everyone. We see children, adults, the uninsured, homeless and the insured individual.”

Five years ago, the federal government announced it would begin fining hospitals if Medicare patients were discharged but had to come back.  Experts argued there was little incentive to follow-up on patients, since medical centers would make more money if people were re-admitted. 

Some hospital administrators dreaded the change, but at the University of Virginia, they’re excited to report dramatic reductions in re-admissions.

As a result of not expanding Medicaid in Virginia, a new state Work Group is examining how to offset rising healthcare costs and the money it passed up from the federal government.  

This includes conducting an analysis of so-called “provider assessments”—which could tax hospitals, nursing homes, and other facilities for specific services.

The provider assessments would enable Virginia to receive matching federal Medicaid dollars. Analyst Deborah Bachrach from Manatt says all of the potential models must follow the same guidelines.