Would You Walk Away from $2 Billion? Then Why Is Virginia (and 26 Other States)?

Hey, I just won the lottery! Two billion dollars! But you know what? I think I’ll just refuse it.

That, dear readers, is what my much beloved state of Virginia is prepared to do. On March 24, the General Assembly meets in a special session to consider the new budget — which is tied to expanding Medicaid. The Republican-led body has already voted against the budget because of the Medicaid requirement.

The expansion is part of the Affordable Care Act. If states expand Medicaid eligibility to those making up to 138 percent of the federal poverty level, including childless adults, the feds will pay for 100 percent of the expansion for the next five years, after which it picks up 90 percent. That’s a big bonus given that the state and the feds split the cost of traditional Medicaid.

Currently, Virginia covers children up to age 19 and pregnant women with  family incomes  up to 133 percent of the poverty level, and parents with family incomes up to 31 percent of the federal poverty level. No matter how poor you are, if you don’t have kids and you’re not pregnant, you’re out of luck.

So let’s take a look at how horrible it would be to expand Medicaid in Virginia.

Well, according to a recent analysis, expanding Medicaid would provide a $3.9 billion boost to the Virginia economy annually and support more than 30,000 new jobs. It could reduce the cost of private insurance, which would, in turn, potentially reduce the cost of health insurance for private employers.

And, by the way, it would provide healthcare coverage to an estimated 400,000 of my fellow residents, most of whom are currently uninsured. That, in turn, would save them about $238.9 million in out-of-pocket healthcare costs in the next five years, money they can spend elsewhere, boosting other parts of the economy.

Here’s the kicker: if the state opts out of the expansion it will spend 7 percent more in the next five years on healthcare costs than if it opted in. That’s because opting in will save millions in spending on uncompensated care (yes, the state has to pay a portion of those medical expenses that the uninsured can’t). It will also bring in increased tax revenues thanks to those new jobs.

Here’s the part that makes it personal: I’m already paying for the expansion with my federal taxes. Shouldn’t that money come back to my own state?

Twenty-six states and the District of Columbia (including several Republican-led states) looked at that lottery check and decided, rightly so, that it would be just plain stupid to tear it up. They’re expanding their Medicaid systems.

Here’s hoping the Old Dominion does the same.

(Wondering if your state is expanding Medicaid? You can find out here).


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