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Making the case for Medicaid
SoVaNow.com / March 20, 2014Gov. Terry McAuliffe visited Halifax Regional Hospital on Tuesday to rally support for expansion of Virginia’s Medicaid program — and by that measure, it was mission accomplished as physicians, hospital officials and community leaders offered their backing.
What McAuliffe didn’t get, however, was encouragement from the people he needs most — Southside’s Republican lawmakers.
Conspicuous by their absence at the Tuesday forum at HRH were Del. James Edmunds and State Senators Frank Ruff and Bill Stanley, who together represent Halifax County in the General Assembly’s upper chamber. The South Boston stopover was the third health care-related stop of the day for the governor; earlier Tuesday, McAuliffe met with representatives of the PATHS community health clinic in Martinsville and Danville Regional Medical Center in Danville.
GOP representatives in those areas also shunned the governor’s tour.
Amid expressions of support by the hospital board and staff for Medicaid expansion, political considerations cropped up in the discussion.
After South Boston Mayor Ed Owens observed that “10 percent of what you pay in insurance premiums is to pay for people who don’t have insurance,” McAuliffe asked Owens if he had communicated his views to local legislators.
Owens said he had, and opined that “politics” was standing in the way of a compromise.
“It shouldn’t be,” interjected McAuliffe.
“It should not be. You’re right about that,” Owens replied.
The Southside swing comes as McAuliffe and the Republican-controlled House of Delegates continue their faceoff on Medicaid expansion, a key provision of the Affordable Care Act that is up to Virginia, and states individually, to implement. McAuliffe and a bipartisan coalition in the State Senate are hoping Virginia will become 27th state to accept Medicaid expansion; the House of Delegates is refusing to go along.
The dispute has tied up agreement on Virginia’s budget, which is due to take effect July 1 of this year, and prompted the convening of a special session. The deadlock also presents a quandary for local governments and school divisions, which depend on state funding for substantial portions of their own budgets.
At Tuesday’s forum, however, the main topic of conversation was what Medicaid expansion would mean for Halifax Regional Hospital and its patients — and what denial of the program would do to the hospital’s bottom line.
Almost half of the patients treated at the hospital’s ER are either uninsured or have coverage through Medicaid — with the former group making up 18 percent of the ER patient caseload, and Medicaid beneficiaries accounting for 29 percent. Due largely to this demographic makeup, Halifax Regional Hospital provided $15.8 million in charity and uncompensated care in 2013.
With the federal government cutting back on payments to hospitals for unpaid care — with the intention of the Medicaid program picking up the slack — hospital officials fretted about what will happen if Virginia refuses to go through with full implementation of the Affordable Care Act.
“There is only so much a small community hospital can absorb without straining our resources and hindering our ability” to provide quality care, said Dr. Habib Bassil, an HRH cardiologist and member of the board of directors.
Halifax Regional President Chris Lumsden said that with all the changes in the health care system, “we don’t see clear skies up ahead, we see cloudy, choppy skies.
“Our greatest fear is we won’t be able to maintain our employees, at least not at the level we do now,” said Lumsden, who touted for McAuliffe the hospital’s record of never having an employee layoff.
McAuliffe, who cited projected job creation in the healthcare sector as a reason for going forward with Medicaid expansion — estimates have placed the number of new jobs somewhere between 22,000 and 30,000 statewide — said action is desperately needed to boost hospitals and clinics in communities such as Halifax.
“We’ve heard [that hospital chains] will shut down hospitals” if Medicaid isn’t expanded, said McAuliffe. “This is serious, serious business.”
McAuliffe and a coalition of Democratic and Republican senators is supporting a private insurance-based program called “Marketplace Virginia” to extend coverage to the Medicaid-eligible population; the program would capture about $1.7 billion in revenue that Virginia is paying towards the Affordable Care Act to expand Medicaid eligibility.
Virginia has one of the stingiest Medicaid programs in the nation; under the proposed reforms, the program would be broadened to cover low-income Virginians making up to $16,105, or $32,913 for a family of four.
The federal government would pick up 100 percent of the cost of new Medicaid beneficiaries for the first three years, eventually falling to 90 percent.
House leaders argue that the federal government cannot afford to pay for the Medicaid expansion, but McAuliffe countered that Virginians are already paying into the program and should reap the benefits in return.
“We’ve already paid these taxes. It’s not like we’re asking you to pay them again,” he said.
McAuliffe sought to frame the issue in business-friendly terms, noting that Virginia actually would improve its own budget situation by accepting billions in federal revenue, while promoting growth in the health care sector.
He also pointed to the closing of a community hospital in Lee County as proof of what could happen if Virginia doesn’t claim Medicaid revenues for low-income areas. Losing health care providers not only harms patients, but entire communities.
“A manufacturer is not going to put an industry in a county where the hospital has closed and their employees have to drive 65 miles” to the next closest hospital, he said.
McAuliffe added that he “cannot understand at this point why House representatives won’t even negotiate with us” on Medicaid expansion and said he would not be swayed by delegates’ calls to convene a special issue on the issue, separating it from budget deliberations.
He called the demand for a special session a stunt and a delaying tactic: “They’ve made it clear they have no intention to [enact the expansion]” and instead are “moving the goalposts.”
With no compromise in sight, McAuliffe said he would continue his efforts to rally support among the public, and noted this wouldn’t be the first time that budget talks in Virginia bumped against the deadline for passage. He cited his predecessor, Republican Gov. Bob McDonnell, who signed a budget the day before it went into effect.
“This is not a unique process,” he said.
CommentsI am sick of democrats giving my money to people that don't work! If you can't afford health care, then sorry you don't get it. When did we become such a soft society. Terry it is tax money not free money. I can't believe that NOVA residents put this guy in office!
- By allpolitical2 on 03 / 20 / 14
Comments"House leaders argue that the federal government cannot afford to pay for the Medicaid expansion" When has that ever stopped an idiot politician, republican or democrat? $17 trillion debt would tend to indicate its not as issue for most.
- By Cynical on 03 / 20 / 14
- By allpolitical3 on 03 / 23 / 14
- By Robert KKK Byrd on 03 / 23 / 14
Government loves you so much.
- By Just following orders on 03 / 23 / 14
Commentsi dont think its right to say if you cant afford insurance then you cant get it what about the people that work a 9 to 5 job but still cant afford insurance
- By a hard working women on 03 / 24 / 14
CommentsThen specifically who should pay for it? Should the doctor be compelled through the use of force by the state to treat you for free? Would you be willing to work 600 hours of community service a year to help cover those costs. If your work week is 5 days that's only 40 hours per week. There are approximately 8760 hours in a year. Would 600 hours community service be too much?
- By Curious on 03 / 24 / 14
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