The Virginia General Assembly returned on March 24, 2014 for a special session to complete the work on passing a budget and to consider options for closing the insurance coverage gap in Virginia.
The Affordable Care Act intended to expand access to health care coverage by increasing Medicaid eligibility to all individuals below 138% of the federal poverty limit and creating health care exchanges that would offer subsidies to individuals with incomes between 100% – 400% of the federal poverty limit. Many Virginia lawmakers have been opposed to expanding Medicaid, citing concerns that it would be too costly to the state budget and noting their opposition to expanding government funded health care.
- Failure to expand Medicaid will leave a coverage gap in Virginia, with many individuals and families currently making less than the federal poverty level, but not otherwise eligible for Medicaid, being ineligible for insurance subsidies on the insurance exchange.
- This means that while a family of four earning between $8,500 and $23,000 would need to pay full price for insurance, those earning more can qualify for subsidies. Nearly 200,000 Virginians fall into this coverage gap, of whom, approximately 70% are working families.
- Virginia businesses already pay over $1 billion per year to insurers to cover costs for care for the uninsured. These costs will continue to rise without closing the coverage gap of the uninsured. Most uninsured Virginians receive care at rural or teaching hospitals. Due to changes in federal funding, these hospitals face a shortfall of over $368M in indigent care funding from 2017-2022 if Virginia does not cover the uninsured.
- Virginia tax payers and businesses forgo $4-$5 million in revenues each day that the Commonwealth does not expand Medicaid coverage.
Neither the Senate nor House passed a bill for Medicaid expansion during the 2014 General Assembly. However, the Senate has proposed an alternative, called Marketplace Virginia, which would seek to use federal money that would otherwise cover Medicaid expansion, to provide insurance premium assistance for low income Virginians, not covered by Medicaid, to purchase insurance through a managed care system. The Senate Finance Committee has posted a presentation of Marketplace Virginia.
The House budget does not contain any provisions for addressing the coverage gap in Virginia and the majority of delegates are opposed to such a provision; the Senate budget includes Marketplace Virginia. Governor McAuliffe is due to release his budget this week; he has indicated that he will not sign a budget that does not contain provisions for closing the coverage gap.
With approximately one million Virginians (13%) currently uninsured, closing the coverage gap will have striking implications for the citizens of Virginia. We urge you to get informed and to contact your state legislator to express your views. You can find contact information for your legislator at the General Assembly website by clicking on Who’s My Legislator at the top of the page and entering your address.
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