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