Health Care

Action Alert! Call Your Legislators for Medicaid Expansion

Icon January 26, 2013 - 23:29   This week, the Virginia House of Delegates and Senate will be making important decisions about the budget - and we need you to take action for Medicaid expansion!    Medicaid expansion would be an enormous help to all Virginians, not just those who would receive Medicaid. Will you call your legislators to tell them to support Medicaid expansion?Click here to find out who your legislators are and their contact information.   When you call, just tell them, "I support Medicaid expansion. Please vote for a budget that includes Medicaid expansion in Virginia!"   Here are some facts about Medicaid expansion if you choose to have a longer conversation with your legislator: Medicaid expansion will add about 30,000 well-paying health care jobs to Virginia’s economy. Over 400,000 people will be covered as a result of Medicaid expansion, including low-income working Virginians that work in places where health insurance is not offered or they cannot afford to purchase coverage that is offered. Some of the people who will be covered under the expansion include parents of children already covered by Medicaid, people with disabilities and people who work in low-wage jobs.  A recent study confirms that expanding Medicaid in Virginia will cost the state LESSover the next six years than if we did not expand. Medicaid expansion will add dollars to our economy, increasing state revenue to provide for critical needs of Virginians.  If Medicaid is expanded to Virginia, more Virginians’ federal tax dollars will be going to help Virginians instead of our tax dollars paying for expansion in other states, like Maryland and California, without the benefits of decreasing health care costs, insuring more people and adding money to our economy.    Thank you for your support of Medicaid expansion in Virginia! 

Statement from Kay Crane, CEO of PATHS, on Medicaid Expansion

Icon January 16, 2013 - 19:31 January 16, 2013 More and more groups are coming out in support of expanding Medicaid in Virignia. Below is a statement from PATHS (Piedmont Access to Health Services, Inc.) CEO Kay Crane about the expansion and what that would mean for people in Virginia. Here is Kay's statement: The U.S. Supreme Court’s ruling on the health reform law (Patient Protection & Affordable Care Act) transformed what was a federal guarantee of expanded Medicaid eligibility for adults to a state option. It is now up to each state to determine whether it will participate in the expansion. Gov. Bob McDonnell has said he isn't willing to support expansion of Medicaid in Virginia because he isn't certain the federal government could uphold its pledge to cover 100 percent of the costs for the first three years. But the notion that the federal government might fail to honor its obligation would also provide the governor with reason to reject federal money for roads or K-12 education. (He hasn't.)The reality is that if Virginia expands Medicaid eligibility to increase coverage, the federal government has agreed to pay 100 percent of the costs through 2016. The feds would gradually phase down their coverage to 90 percent in 2021. One thing that is certain: Hospitals, community health centers and people with private insurance will cover the extra costs if Medicaid is not expanded. The reason for the loss is simple. Federal funds designed to offset the providers' costs for caring for uninsured patients are set to be reduced because Obamacare essentially substitutes Medicaid coverage for those subsidies. If more patients are covered by Medicaid, there is less need for payments to subsidize treatment of the uninsured. This will be a very important decision in Virginia, because our current Medicaid eligibility level is one of the lowest in the country (30% FPL for parents and 80% FPL for the aged, blind and disabled). As a result, an estimated 420,000 uninsured Virginians would become insured under the Medicaid expansion. There seem to be misconceptions about those who would become eligible for coverage under the Medicaid expansion. Too often, people think in terms of the negative welfare stereotypes. This creates hostility and opposition to providing the coverage that so many of our patients need.  There are many adults who have worked hard and find themselves either laid off from their job and disabled who do not have insurance.  Having access to Medicaid would benefit this population. In our health centers we have many patients whose lives would be made so much better if they qualified for Medicaid.  One patient that comes to mind is a 59 year old woman that I know. She and her husband worked at Dan River all their lives.  When Dan River,  closed they lost their jobs and their health insurance.  Her husband was older and qualified for Medicare, but she did not.  Unfortunately, and tragically, she was diagnosed with throat cancer and did not qualify for Medicaid because even though they lived on her husband’s fixed social security income, they did own their home.  Tragically, she chose not to have treatment for her cancer for one simple reason -  she did not want to leave her husband with huge medical bills that would put him in danger of losing the home they had worked so hard to pay for. By the time she found her way to our health center, she was in the final stages of this cancer. All we could do was arrange for Hospice and palliative care to help with the pain and allow her to die with dignity.  She passed away in June. Left behind, is a grief stricken family,  who wondered - why did it have to be this way? In a country where we spend more on health care than any other country in the free world, why are our friends, family, and neighbors having to make these difficult decisions?  As the General Assembly convenes there will be many issues before them. None of those issues will be as important as Medicaid expansion – their decisions on Medicaid will have a direct impact on lives of thousands of individuals just like this woman – lives that could be saved.   Kay Crane PATHS CEO

Medicaid Expansion Costs Predicted to be Far Lower than Estimated

Icon January 15, 2013 - 14:51   BY MICHAEL MARTZ Richmond Times-Dispatch http://www.timesdispatch.com/news/state-regional/medicaid-expansion-costs-predicted-to-be-far-lower-than-estimated/article_2a7a6e14-a165-5daf-86a8-977c8dd4eaf6.html The administration of Gov. Bob McDonnell estimates that expanding Virginia’s Medicaid program would cost the state $137.5 million over nine years, far lower than previous estimates that have ranged as high as $2.2 billion. The estimate reflects $584.3 million in expected savings in the first five years of the expansion, although $142.2 million in net savings come from provisions of the Affordable Care Act that do not depend on Medicaid expansion. The cost to Virginia would begin to rise in 2019 and total about $722 million through 2022 as the state assumes a 10 percent share of the bill under the federal law. The federal share of the cost of expansion in Virginia would exceed $23 billion over nine years — including 100 percent of the bill the first three years. “It is a significant amount of federal money,” Secretary of Health and Human Resources William A. Hazel Jr. told a Senate Finance subcommittee last week. “We do have concerns about whether that federal money will be there.” The new estimates, compiled over the past seven months by the Virginia Department of Medical Assistance Services, emerge as the General Assembly prepares to debate whether to expand the federal-state program for the poor in the face of opposition by McDonnell and other Republican leaders. “As the state is conducting a more thorough analysis … the costs to Virginia are going lower and lower, making this an even better opportunity for Virginia to move forward with expansion,” said Jill A. Hanken, staff attorney for the Virginia Poverty Law Center. The estimates do not reflect the potential economic benefits of the expansion — predicted at almost $4 billion a year in Virginia in a study commissioned by the state hospital association that forecasts the creation of more than 30,000 jobs and significant increases in tax revenues. With those potential benefits, Hanken said, “the bottom line is the expansion pays for itself.” The lowest cost estimate is based on the expectation that fewer Virginians would take advantage of expanded eligibility for Medicaid on Jan. 14, 2014 — about 248,000, or 69 percent of all those expected to be eligible. The cost to the state would be close to $1 billion over nine years if all of those eligible enrolled in the program initially — more than 400,000 Virginians. Most of the newly eligible would be childless adults and parents who don’t qualify now under Virginia’s program, ranked 48th in the country for eligibility and benefits. More than two years ago, the state estimated the cost of expansion at $2.2 billion over 10 years. Medicaid officials say they assumed then that all of those newly eligible would apply for coverage, so the new analysis effectively reduces that estimate by about half. The new analysis estimates substantial savings, almost $300 million, if behavioral health benefits are included in the Medicaid expansion because in many cases the state is paying for those services without federal help. “This would substitute Medicaid funding at 100 percent federal for a lot of services that are currently state-funded,” said Scott Crawford, deputy Medicaid director for finance. Virginia also would save almost $290 million in hospital care of inmates in the Department of Corrections who currently don’t qualify for Medicaid, the analysis estimates. But the biggest savings would come from reduced state reimbursements for hospitals — especially teaching hospitals at Virginia Commonwealth University and the University of Virginia — for the uncompensated care they provide to Virginians with no or little health insurance. The analysis estimates those savings to the state at $637.4 million over nine years, or about half an estimated $1.3 billion in reduced federal and state reimbursements to hospitals for indigent care. On the other hand, the analysis estimates a much bigger bill for Virginia if the state were to fully fund the cost of hospital care to Medicaid patients — now reimbursed at less than 70 percent of the cost — and raise rates for doctors and other providers by 25 percent to the level currently paid by Medicare. If Virginia raised those hospital and provider payment rates, it would cost $3.1 billion to $4 billion through 2022. Under the Affordable Care Act, the federal government will pay the higher Medicaid rates for primary care services beginning this year and continuing through 2014. States will have to decide whether to pay a share of the bill beginning in 2015 or lower the payment rates. All of the estimates assume that the federal government provides the funding promised in the Affordable Care Act, and even advocates agree that expansion of Virginia’s Medicaid program should be linked to the federal match rates in the law. McDonnell and Republican legislative leaders also want flexibility in how the state would administer the Medicaid program to newly eligible Virginians and, eventually, those already covered by it. “Without dramatic reform, I cannot recommend a dramatic Medicaid expansion,” the governor said in his State of the Commonwealth speech last week. The McDonnell administration is submitting a waiver to the federal government under Section 1115 of the Social Security Act that would give the state flexibility in how it designs benefits, requires recipients to share costs, promotes effective care, and simplifies administration of the program. Virginia Medicaid officials plan to meet with their federal counterparts in early February to discuss the state’s request. The state also is seeking an agreement with the Department of Health and Human Services to undertake a pilot project to reduce the high cost of care for elderly and disabled Virginians who are eligible for both Medicaid and Medicare benefits. Last month, Health and Human Services Secretary Kathleen Sebelius encouraged states to undertake such reforms and take advantage of federal waiver “demonstrations” to change how they deliver and pay for care. The federal Medicaid program “continues to work closely with states to provide options and tools that make it easier for states to make changes in their Medicaid programs to improve care and lower costs,” Sebelius said in guidance released Dec. 10. Ranking Republicans on both assembly money committees submitted budget amendments on Friday to allow state Medicaid officials to negotiate reforms with the federal government as a step toward possibly expanding the state program. “Most of us are very comfortable with the approach of reform first and then consider expanding later,” said Del. John M. O’Bannon III, R-Henrico, a member of the House Appropriations Committee who requested the amendment. Sen. Emmett W. Hanger Jr., R-Augusta, who chairs the Senate Finance subcommittee on health and human resources, filed a similar amendment to condition expansion on reforms and federal funding. “We have an opportunity, as long as we get the conditions, to do it Virginia’s way,” Hanger said Friday.

Group: Medicaid expansion will add 30,000 jobs and billions to Va. economy

Icon January 11, 2013 - 17:13 January 11, 2013 Monique Coppola, Public News Service-VA http://www.publicnewsservice.org/index.php?/content/article/30172-1 (01/11/13) RICHMOND, Va. – Virginia Governor Bob McDonnell said in his State of the Commonwealth Address this week that he will not support the Medicaid expansion in Virginia, which is part of the federal health care reform law. The governor’s new budget reflects this decision.  Jill Hanken, an attorney with the Virginia Poverty Law Center, says the governor has stripped $1.1 billion from the budget– an amount she says is approaching what would come from the federal government to pay for Virginia's Medicaid expansion beginning January 2014. "The federal government pays the entire cost of the expansion for the first three years, and this is bringing $2 billion a year into Virginia – which would be used not just for health services for low-income people, but it would support hospitals, businesses and overall economic activity." According to a recent study by Chmura Economics and Analytics in Richmond, the Medicaid expansion in Virginia would produce about 30,000 jobs, mostly in the medical field. After 2019, the state would be required to cover 10 percent of the costs for the expansion.  Hanken says the state's share is dwarfed by the amount of federal dollars that will be rolling into the state. According to the Virginia Senate Finance Committee, the state spent more than $1 billion over the course of a 10-year period to subsidize indigent care at the University of Virginia and Commonwealth University Health Care Systems.  Hanken says federal funds for the expansion of Medicaid would offset these state costs. "Also when hospitals do provide indigent care services, it affects all of us, our own health care insurance premiums go up by about a thousand dollars a year." Hanken adds that Virginia has one of the most restrictive Medicaid programs in the entire country, but the expansion would alter this and about 400,000 Virginians could qualify for Medicaid health insurance.  The Virginia General Assembly will decide during its 2013 session whether to adopt the Medicaid expansion.    

Study: Va. would pay more if Medicaid not expanded

Icon January 5, 2013 - 16:09 January 5, 2013 By Michael Martz http://www.timesdispatch.com/news/study-va-would-pay-more-if-medicaid-not-expanded/article_d7d716b0-8888-589e-9e09-66a9a40655df.html A new economic study for Virginia’s powerful hospital and health care industry says the state would pay more for Medicaid in the near term if it chooses not to expand the health program to more than 300,000 uninsured Virginians. At the same time, the study for the Virginia Hospital and Healthcare Association says the state would forgo estimated economic benefits from expanding Medicaid that would be more than four times those from opting out of the expansion. Chmura Economics & Analytics, a Richmond firm hired to perform the study, found that expanding Medicaid under the federal Affordable Care Act would generate an economic benefit to the state of nearly $4 billion a year over the next six years, driven by a huge increase in federal spending that would produce almost 31,000 jobs, most of them in the health care industry. But the study’s biggest revelation was the cost to the state budget of expanding Medicaid — it would be about 7 percent less than if Virginia opted out of the expansion. “That is a surprising result,” said Christopher S. Bailey, senior vice president at the association. Expansion would cost Virginia less in the near term because the Affordable Care Act promises full federal funding for the first three years of the six-year study period, the Chmura report said. The state also would benefit from “a significant reduction” in reimbursements of uncompensated care for uninsured Virginians, as well as new state tax revenue from investments by the expanded health care industry, businesses and individuals who save on health care costs. However, Bailey said the study does not address increased state financial support of the expansion after 2019. It also does not address, in detail, concerns about the possibility of less federal aid than promised because of deficit reduction and the lack of control over expenses in operating the Medicaid program now. “It doesn’t do anything to change the reality that we’re going to have to figure out a way to manage Medicaid sustainability more successfully over the long term,” Bailey said. Secretary of Health and Human Resources William A. Hazel Jr. came to the same conclusion. “You’re still going to have to look at the cost-benefit analysis, because this is only the benefit,” he said Thursday. Hazel said the state is concerned about where it would find the money to fund its share of the expansion, especially after 2019, when the state would pay 10 percent of the cost of expansion. “There is a huge jump (in costs) in the out years,” he said. Gov. Bob McDonnell opposes Medicaid expansion without significant reforms to the program, but his administration is working closely with the U.S. Department of Health & Human Services on waivers and pilot projects that would give the state flexibility in how it operates and pays for the program. A federal decision on those state requests could come during the General Assembly session that will begin on Wednesday. Medicaid expansion will be one of the biggest items on the legislature’s agenda. Sen. Emmett W. Hanger Jr., R-Augusta, said Friday he will introduce amendments to the state budget that will put Medicaid expansion “on the table, so we can consider it during the session.” Hanger, chairman of the Senate Finance health and human resources subcommittee, said he also will introduce a budget amendment to allow a “hybrid” health benefits exchange to be operated in partnership between the state and federal governments, instead of defaulting to a federally operated exchange. Medicaid expansion and establishment of a health benefits exchange are the most crucial components of the Affordable Care Act’s goal of extending health insurance coverage to an estimated 1 million uninsured Virginians. Virginia’s policy decisions will have enormous ramifications for the state’s hospitals and health insurers, which are counting on expanded health coverage to bring down the costs of uncompensated medical care. “These are opportunities to get more people enrolled to share the costs,” said Doug Gray, executive director of the Virginia Association of Health Plans. The effect on the state budget would be an estimated increase of $244.7 million a year, on average, if the Medicaid program expands and $261.9 million if it does not, the study estimates. One of the biggest reasons for the difference is an estimated state savings of $69.2 million a year as Virginia’s share of reimbursements to hospitals for uncompensated care. Virginia Commonwealth University and University of Virginia medical centers provide most of the uncompensated care in the state and stand most to lose if reimbursements shrink but Medicaid does not expand to reduce the number of uninsured people they treat. “There is no place (for hospitals) to go for uncompensated care if they don’t expand Medicaid,” Gray said. Virginia will pay more for Medicaid regardless of whether it expands the program, the study concludes, because almost 90,000 people are expected to apply for benefits to which they already are entitled as other health care reforms spur them to act. This is the so-called “coming out of the woodwork effect.” The state would share equally with the federal government in the cost of care for those people, while the state would pay none of the cost of care for newly eligible Medicaid participants under expansion for the first three years. Its share would increase gradually to 7 percent of the cost over the next three years and 10 percent thereafter. Expansion would extend coverage to about 310,000 Virginians who aren’t eligible now, the hospital association study estimates, although it said state officials are doing a more detailed study of the likely “take-up” of benefits. The state has not released the study. But the essence of the hospital association study is the effect of federal spending estimated at almost $1.9 billion a year, on average, from 2014 through 2019. That spending would generate an average of almost $3.5 billion a year in the health care sector alone and produce more than 26,000 jobs, the study estimates. The total economic benefit, estimated at $3.9 billion a year, on average, includes $34.6 billion for businesses that would reinvest projected savings on employee health insurance and $417.7 million in spending by people who no longer have to pay out of pocket for any medical care they get. In contrast, if Virginia does not expand its Medicaid program, federal spending still would increase because of the “woodwork effect” and have an economic spinoff that would produce a total estimated benefit of $878.2 million a year, on average, in the six-year period. “The near term benefits (of expansion) are very significant,” Bailey said. “We need to use those benefits to fix the long-term problem.”

A Report from Virginia’s Internal Medicine Physician Specialists: How Will the Medicaid Expansion Benefit Virginia?

Icon December 21, 2012 - 16:44 The following is a report from the Virginia Chapter of the American College of Physicians on why Medicaid expansion is vital to Virginia residents. The full report with references and tables can be found at: http://www.acponline.org/about_acp/chapters/va/medicaid_report.pdf  In light of the Supreme Court’s ruling on the Affordable Care Act’s Medicaid expansion, states now have the option of expanding their Medicaid programs to all individuals with incomes up to 133% of the federal poverty level (FPL), which is equal to $14,856 for an individual or $30,656 for a family of 4 in 2012.  The federal government will finance most of the expansion’s cost. From 2014 to 2016, the federal government will pay for 100% of the coverage expansion. States will gradually assume a portion of the cost, providing 10% of expenses starting in 2020.   Now that the Medicaid expansion is optional, it’s estimated that fewer uninsured people will be able to access Medicaid. The Congressional Budget Office (CBO) originally estimated that 16 million people would be covered by the ACA Medicaid expansion. As a result, the CBO predicts that 6 million fewer individuals will be covered by Medicaid, although 3 million of these will be eligible for exchange-based private insurance. The Virginia Chapter of the American College of Physicians believes that it is imperative that the Commonwealth of Virginia accept the unique opportunity that is now available to use federal dollars to expand Medicaid to everyone who has an income up to 133% of the federal poverty level.  The report explains why it is in the best interests of the residents of this Commonwealth, the physicians and hospitals who deliver care to them, and the Commonwealth itself to agree to do so.  Our organization represents 3,361 internal medicine specialists and medical student members who live, study, teach and practice in the Commonwealth of Virginia.  We are a chapter of the American College of Physicians, which represents 133,000 internal medicine and medical student members nationwide.  ACP is the largest physician specialty society and second largest physician-membership organization in the United States. No matter where one stands on the Affordable Care Act itself, the evidence is clear: Virginia will greatly benefit by accepting federal dollars to extend Medicaid, and Virginians will be harmed it if does not:  Extending Medicaid coverage to Virginia’s low-income uninsured will improve health status and quality of life. Numerous studies show that individuals who enroll in Medicaid benefit significantly compared with the uninsured. ·      For instance, a study comparing Oregon Medicaid enrollees with uninsured people found that 35% of Medicaid enrollees were more likely to receive outpatient care compared to the uninsured. Seventy percent of Medicaid enrollees reported having access to a regular source of primary care, and 55% were more likely to have a doctor they usually see, compared with the uninsured. ·      Medicaid coverage also reduces mortality. One study concluded that mortality declined after states expanded their Medicaid programs, particularly among those aged 35 to 64 years, minorities, and people living in poorer areas. ·      Medicaid coverage may also help curb racial and ethnic health care disparities that are exasperated by lack of insurance, such as lack of usual source of care or receipt of preventative screenings. About 42% of adult Virginians newly-eligible for Medicaid are people of color, a population that is more likely to be uninsured than whites.  Extending Medicaid coverage will reduce the numbers of uninsured Virginians by as much as 37 percent. ·      Thirteen percent of Virginians – over one million people – were uninsured between 2009 and 2010. According to one estimate, 412,000 adult Virginians would be eligible for Medicaid coverage, including 342,000 who would be newly eligible under the health reform law.5    ·      This is a significant expansion, as childless, non-disabled adults are currently ineligible for Virginia’s Medicaid program. The Commonwealth currently restricts eligibility to working parents with incomes up to $5,744 (for a family of three) and non-working parents with incomes up to $4,633.  Medicaid expansion will help the “safety net” of physicians, hospitals, and academic medical centers better serve their low-income patients and reduce cost-shifting to the rest of us.  In anticipation of the Medicaid expansion, the health reform law increases Medicaid primary care payments to Medicare levels in 2013 and 2014, paid for entirely by the federal government at no cost to Virginia.  In addition, a reduction in uncompensated care will help the “bottom line” of Virginia’s hospitals and physician clinics that take care of Medicaid patients, and the state and local governments that help fund indigent care. ·      In 2008, the last year for which information is available, Virginia’s Medicaid primary care payment rates were 88% of Medicare rates. While Medicaid physician participation lags behind Medicare and private insurance, evidence shows that physicians are more likely to accept new Medicaid patients in states that pay closer to Medicare rates. ·      Hospitals will benefit from reduced uncompensated care costs, as the newly-insured will no longer be forced to seek free care provided by hospitals. Uncompensated care costs are shared across the public and private sectors. ·      It’s estimated that state and local governments provide 30% of the cost of uncompensated care. By expanding Medicaid to cover the previously uninsured, Virginia would benefit from a portion of uncompensated care savings. ·      The Medicaid expansion is especially crucial for hospitals, since the health care reform law cut the federal share of uncompensated care payments because lawmakers assumed the Medicaid expansion would heavily reduce the need for uncompensated care. In 2010, Virginia hospitals received about $88 million in Medicaid federal funds to help offset the cost of covering the uninsured. In addition, everyone in Virginia pays for the care that is provided on an uncompensated basis by hospitals and physicians, because those costs are shifted to the rest of us through higher premiums for our health insurance and higher taxes for government safety-net programs.  And every one of us will benefit when there is less uncompensated care because more Virginia will be covered by Medicaid.  The Commonwealth will benefit fiscally by accepting this unprecedented offer by the federal government to pay almost all of the costs of extending Medicaid to more Virginians. Medicaid’s rising costs are a growing burden for Virginians, mainly because the federal government does not pay a fair share of Medicaid costs while imposing costly federal mandates on the Commonwealth.  But this new program is different, because the federal government pays almost the entire cost. ·      Right now, the federal government pays about 50% of the cost for Virginians enrolled in Medicaid; our Commonwealth pays the other 50%. ·      But starting in 2014, the federal government will pay 100% of the cost—yes, all of it!—for the first two years of extending Medicaid to all Virginians with incomes below 133% of the federal poverty level.  ·      Gradually, the federal government’s share will go down to 95% and then 90% over the next ten years. ·      Still, the federal contribution would be the most ever offered to Virginians to cover more of our residents.  ·      The CBO estimates that states will incur an additional 2.8% increase in Medicaid costs compared with what they would have spent in absence of the health care law, an estimate that includes those currently eligible for Medicaid coverage. ·      A Kaiser Family Foundation study predicts a 1.8% increase in Virginia’s Medicaid spending from 2014-2019. However, a 2011 Urban Institute report estimated that the ACA could save Virginia up to $146 million over 2014-2019 when enhanced Medicaid spending, uncompensated care reductions, and other savings are factored in. ·      If Virginia waits to accept the federal offer to pay for the Medicaid extension, it will get less help from the federal government.  100% federal funding is available only in 2014-15, so if Virginia waits until 2016, the federal government’s initial contribution will be 95% of the cost.  If Virginia waits until 2020, the federal government’s annual contribution will be 90% of the cost.  Delay now means ·      Virginia taxpayers will pay more later to cover the same people under Medicaid. ·      Should Virginia accept the federal dollars now, the Commonwealth is not locked in if the federal government reneges in the future on the commitment to pay for most of the Medicaid expansion.  If the federal payments are reduced, then Virginia could revisit its decision to expand Medicaid.  What would happen to the uninsured if Virginia chose not to expand Medicaid? The Urban Institute estimates that about 271,000 uninsured adult Virginians with incomes under 100% FPL would be denied coverage if Virginia chooses not to expand its Medicaid program. And, under the health reform law, they would not be eligible to get the subsidies to help pay for health insurance available to people who earn more than the federal poverty level, because Congress had expected that they would be covered by Medicaid. Think about that: if Virginia turns down or delays accepting the federal money to extend Medicaid, we will be leaving our poorest residents with no other way to get coverage—resulting in poorer health outcomes for them, more uncompensated care for hospitals and physicians who take care of them, more cost-shifting for the rest of us, and ultimately, higher cost to the Commonwealth. As an organization representing Virginia’s internal medicine physicians and medical students, our greatest concern is for the working people—our patients—who will be left behind without any access to health insurance coverage if Virginia declines the federal money to expand Medicaid.  We are speaking for them when we ask Governor McDonnell and the Virginia legislature to do the right thing and accept this unprecedented opportunity to provide coverage to our poorest patients, at minimal cost to the Commonwealth.

We Can't Afford to NOT Expand Medicaid!

Icon December 19, 2012 - 17:15 This week, one of the Nuns on the Bus, Sister Mary Ellen Lacy, came to Fredericksburg and Richmond to discuss the importance of Medicaid expansion in Virginia.  This is timely, since Governor Bob McDonnell announced on Monday that he would not keep the federal money in the state budget to expand Medicaid. While the fight for Medicaid expansion is not over, this is certainly disappointing to over 400,000 Virginians who were hoping that the Governor would lead the charge in ensuring they receive health care at no cost to the state.     We know that Medicaid expansion will cover more than 400,000 additional Virginians at no cost to Virginia.In fact, the Governor's removal of the federal funds from the budget hurts Virginia in other ways too.   Expanding Medicaid in Virginia is estimated to create 30,000 well-paying jobs, which helps our economy grow. In addition, it will help hospitals and other providers who are currently servicing uninsured Virginians at a high cost to their business. Nowhere is this more evident than in Southern and Southwest Virginia where residents in rural areas could gain health coverage if Medicaid expansion were implemented in Virginia.    But Sister Mary Ellen and the other speakers made a great point: this is not just an economic issue, it is anissue of morality. Will we be a state that lets people die because of a lack of access to health care? When people delay treatment because they can't access affordable health care, they may wait until it's too late.   The bottom line is that we can't afford to NOT expand Medicaid - financially or morally.    At Virginia Organizing, we believe when people come together to create change, our system works better for everyone. Medicaid expansion is no different. When we pool our resources into the highly effective and efficient insurance program (Medicaid), we help provide for our neighbors, our friends, and our brothers and sisters.    Today, we are asking that each of our supporters take action! We've created a template to make it easy! Click here to be taken to our action page and send letters to Governor Bob McDonnell and your state legislators. Let them know that Medicaid expansion is essential to Virginia and we need to take advantage of this program now! Share this with your family and friends and ask them to raise their voices in support of a better Virginia.    Our legislators are about to begin the General Assembly session and now is a great time to remind them that they work for you! During our Richmond Nuns on the Bus event, Delegate Jennifer McClellan affirmed what we already know: your stories, your calls, your letters, your emails, your words all make a difference and can change the minds, hearts, and votes of your representatives. Let's make a difference today!   Sincerely,   Sandra A. Cook Chairperson   Pictured: Jay (Fredericksburg resident), Dr. Chris Lillis (Doctors for America), and Sister Mary Ellen Lacy (NETWORK)

Medicaid Expansion Covers Millions at "Modest" Cost to States: Report

Icon November 28, 2012 - 15:46 By Jeffrey Young November 26, 2012 http://www.huffingtonpost.com/2012/11/26/medicaid-expansion_n_2191912.html Expanding Medicaid health benefits to everyone eligible under President Barack Obama's health care reform law would increase state spending on the program by just 3 percent while extending health coverage to more than 20 million people, according to a study released Monday by the Henry J. Kaiser Family Foundation and the Urban Institute. The health care law seeks to enroll into the Medicaid program anyone who earns up to 133 percent of the federal poverty level, which is $14,856 this year. But when the Supreme Court upheld the law in June, its decision allowed states to opt out of the Medicaid expansion. So far, governors in eight states have declared they won't participate, denying health care coverage to millions of their poorest residents. But the states' share of the new costs of covering more people on Medicaid is relatively small. Combined with greater private health insurance coverage, Medicaid expansion would result in a large reduction in the number of uninsured people, and fewer unpaid medical bills that raise costs for taxpayers. "By implementing the Medicaid expansion with other provisions of the ACA, states could significantly reduce the number of uninsured," the Kaiser Family Foundation and Urban Institute study states. "Overall state costs of implementing the Medicaid expansion would be modest compared to increases in federal funds, and many states are likely to see small net budget gains." The total cost of the Medicaid expansion would be $1.03 trillion between 2013 and 2022, according to the study. States would pay $76 billion of that, which amounts to a 2.9 percent increase compared to what states would have spent on Medicaid if the health care reform law hadn't been enacted. Under the health care reform law, the federal government will pay the full cost of covering newly eligible people on Medicaid from 2014 to 2016, then will scale back funding to 90 percent in 2022 and later years. In addition to receiving a large federal subsidy to enroll these uninsured residents, states that expand Medicaid would be able to reduce spending on taxpayer-funded programs to help hospitals and other health care providers cover the cost of so-called uncompensated care, or unpaid medical bills. If Medicaid expanded across the country, states would save $18 billion between 2013 to 2022 , according to the study. Expanding Medicaid in every state would add 21.3 million people to the Medicaid rolls, including 14.3 million people who will be newly eligible for the program and 7 million people who already are entitled to benefits but aren't signed up. The Congressional Budget Office previously estimated that states opting out of the Medicaid expansion would result in 3 million fewer people gaining health coverage overall under the law. In total, the health care reform law will provide health coverage to 30 million people via Medicaid and private health insurance by 2022, the Congressional Budget Office projects. Seven states and the District of Columbia would actually save money by expanding their Medicaid programs because they already cover some of the people who would receive benefits and Obamacare increases the federal government's share of the costs for them, according to the report. States' costs will vary based on how many residents enroll in the Medicaid expansion. While a handful would save money, others would have to increase their Medicaid budgets. About half of states will see increases of less than 5 percent and the remainder would have to boost spending by 5 percent to 11 percent, according to the Kaiser Family Foundation and the Urban Institute. Eleven states and the District of Columbia plan to enact the Medicaid expansion in 2014 or already have started, and the remainder are undecided, according to the Advisory Board, a consulting company.