By Andy Soergel
After a week of media speculation surrounding Virginia’s possible Medicaid expansion, Gov. Bob McDonnell announced Tuesday night that he has no immediate plans to extend government-funded medical coverage.
“As governor, while the decision currently rests with me on whether or not to expand, I am not going to do so given the vast reform required to make our program cost effective,” McDonnell wrote in a letter to U.S. Secretary of Health and Human Services Kathleen Sebelius.
An amendment to the budget passed in the final days of the General Assembly opened Virginia to the possibility of Medicaid reform. Some reports have interpreted this as a green light to expand medical coverage to more than 400,000 uninsured Virginians. McDonnell’s letter to Sebelius was intended
to clarify the state’s intentions, said gubernatorial spokesman J. Tucker Martin.
“Some media outlets and elected officials have labeled this as approving Medicaid expansion in Virginia,” McDonnell wrote. “This is absolutely incorrect.”
The amendment in question established a 12-member committee called the Medicaid Innovation and Reform Commission (MIRC). The group will oversee possibilities for Medicaid expansion under the state’s budget restrictions. Five senators, five delegates, and two people appointed by the governor will serve on the commission.
McDonnell insists that the establishment of the MIRC will not necessarily lead to future Medicaid reform.
“Members of the commission have already been appointed by the House of Delegates, and several have already expressed deep concern about expansion,” McDonnell wrote.
President Obama’s federal Patient Protection and Affordable Care Act, signed into law in 2010, gives states the option to offer medical insurance coverage to people with annual incomes up to about $26,300 for a family of three, or 138 percent of the national poverty level. Many states have not yet embraced this option for Medicaid expansion.
Medicaid pays for medical services for uninsured, low-income, elderly, and disabled citizens. Virginia ranks 48th out of 50 states in terms of per-capita Medicaid expenditures, says the Department of Medical Assistance Services. Only Texas and California spend less on qualifying individuals per citizen. Working parents in Virginia must earn less than $6,000 annually to qualify for coverage.
Additionally, Virginians paid the highest percentage of premium costs for employer-provided insurance of workers in any state, according to the Virginia Health Care Foundation. Medicaid does not cover premiums paid out of pocket for medical procedures, so even low-income workers able to get insurance still face steep healthcare costs.
To help balance the combination of low Medicaid spending and high premium charges, the federal government has offered to subsidize 100 percent of the states’ Medicaid expansion costs over the first three years of reform. After that time, the government will cut back subsidies to 90 percent of the total cost.
McDonnell said he has concerns over what Medicaid expansion will mean for state and federal budgets.
“I continue to be strongly opposed to many of the policies in the Patient Protection and Affordable Care Act for addressing America’s health care challenges,” he wrote in Tuesday’s letter. “The federal mandates, regulations, taxes and spending create an expensive, top-down, bureaucratic system.”
Despite McDonnell’s concerns, the MIRC is slated to begin operation in June. It will then officially determine what pathMedicaid reform will take in Virginia.