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No delays for health care expansion
Federal officials are willing to give Virginia and other states flexibility in implementing health care reforms. Uninsured Virginians can’t wait any longer.
Wednesday, February 6, 2013
State legislators are taking a passive-aggressive approach to a planned expansion of Medicaid, the government-funded health insurance program, to cover low-income workers. In short, lawmakers are stalling.
But delaying this key initiative of the Patient Protection and Affordable Care Act is unnecessary and costly. Costly to at least 250,000 uninsured Virginians who have the chance to obtain access to medical care starting in January 2014. And costly to taxpayers, who will lose $5 million in federal funding every day that their elected officials refuse to act. That’s $5 million in federal taxes paid by Virginians that will go to other states.
State senators are closer to reaching a bipartisan accord that will allow expansion to continue on schedule. But they must act quickly to repair political damages from a last-minute budget amendment that could postpone the Medicaid expansion for at least six months. The poison pill was inserted without consulting Democrats, who promise to block the entire state budget unless it is removed.
Some Senate Republicans recognize the partisan mischief could undermine more serious goals. They want permission from the federal government to scale down benefits, exclude transportation expenses, for example, and to include cost-sharing requirements for new enrollees.
Dr. Bill Hazel, Virginia’s secretary of health and human resources, told a Roanoke audience this week he’s been discussing the state’s request for flexibility with federal officials. In recent regulatory guidance, the Obama administration has signaled its willingness to cooperate with Virginia and other states on reforms. All of that suggests agreement should be quick and easy; there is no need for an extra six months of dallying.
Even if senators resolve their internal dispute, they face a more daunting task in negotiations with House budget leaders. Delegates have set a far higher bar for participation in the Medicaid expansion in their budget, delaying medical coverage for working-class families for many years.
Delegates lay out a convoluted three-step process to reach expansion. The first step requires vaguely defined changes to the state’s existing managed care Medicaid program. The second step calls for switching the remainder of current Medicaid patients to managed care, including nursing home residents, a process requiring years and mountains of paperwork to accomplish.
The message buried in the verbiage is that delegates don’t really want more Virginians to receive health insurance. Ironically, those reforms could be supported by the additional federal aid due Virginia if it agrees to the expansion.
Participation will cost Virginia nothing for three years. After that, the state’s share is capped at 10 percent. Despite Gov. Bob McDonnell’s initial warning that reform would cost state taxpayers $2.2 billion over 10 years, the latest estimate from his administration is just $137 million. That’s a reasonable price for providing thousands of families with stable medical coverage while steering them away from hospital emergency rooms, where the cost is covered by taxpayer subsidies for charitable care and inflated prices for the privately insured.
It’s time for legislators to quit stalling and get moving on a better health care system for Virginia.
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