Health Care

Last Chance to Act on Medicaid Expansion!

Icon February 20, 2013 - 00:16 February 19, 2013 IT'S YOUR LAST CHANCE TO AFFECT THE DECISION OF THE CONFERENCE COMMITTEE ON MEDICAID EXPANSION! The deadline for the Conference Committee report has been extended, but not for long!    Will you take the time to contact your legislators before Thursday and simply say, "Please support the Senate budget amendment to expand Medicaid without delay! Virginians cannot wait."   This means you still have a chance to let your voice be heard in support of Medicaid expansion. If you have not called your Delegate and Senator, will you please take time to do that now? If you have called your legislators, call them again, ask your friends to call, and make sure you call Governor Bob McDonnell at 804-786-2211.   If your legislators are on the Conference Committee (listed below), we need you to contact them immediately. If your legislators are not on the Conference Committee, it is still important for you to call them now! Click here to find out who your legislators are and how to contact them.    The Virginia Senate and House of Delegates have named the following legislators to the Conference Committee on the Budget — they will decide if Medicaid expansion will be implemented in Virginia without delay.   House of Delegates Conferees Lacey Putney Steven Landes Beverly Sherwood Kirk Cox Chris Jones Johnny Joannou   Senate Conferees Walter Stosch Janet Howell Charles Colgan Emmett Hanger John Watkins Thomas Norment   The House version of the budget bill requires reforms of the Medicaid program before the General Assembly can even consider implementing Medicaid expansion in Virginia. This approach will delay the decision whether or not to proceed with expanding Medicaid to low-income workers and individuals until at least the next General Assembly session.   The Senate version of the budget bill includes reforms and expansion of Medicaid without delay. This means that Virginia would be able to begin Medicaid expansion as early as January 1, 2014. If we expand Medicaid without delay, more Virginians’ tax dollars will support the people of Virginia instead of going to other states that have already taken steps to expand Medicaid. Every day we delay expansion after January 1, 2014, we lose approximately $5 million of federal funding.   Thanks for all your hard work on this issue! 

A Valentine for Medicaid Expansion: Action Alert!

Icon February 14, 2013 - 16:00 February 14, 2013   "Roses are red," Begins poems today. We need Medicaid expansion, Virginia cannot delay!     The Virginia Senate and House of Delegates have named the following legislators to the Conference Committee on the Budget — they will decide if Medicaid expansion will be implemented in Virginia without delay.   House of Delegates Conferees Lacey Putney Steven Landes Beverly Sherwood Kirk Cox Chris Jones Johnny Joannou   Senate Conferees Walter Stosch Janet Howell Charles Colgan Emmett Hanger John Watkins Thomas Norment   The House version of the budget bill requires reforms of the Medicaid program beforethe General Assembly can even consider implementing Medicaid expansion in Virginia. This approach will delay the decision whether or not to proceed with expanding Medicaid to low-income workers and individuals until at least the next General Assembly session.   The Senate version of the budget bill includes reforms and expansion of Medicaid without delay. This means that Virginia would be able to begin Medicaid expansion as early as January 1, 2014. If we expand Medicaid without delay, more Virginians’ tax dollars will support the people of Virginia instead of going to other states that have already taken steps to expand Medicaid. Every day we delay expansion after January 1, 2014, we lose approximately $5 million of federal funding.   If your legislators are on the Conference Committee (above), we need you to contact them immediately.   If your legislators are not on the Conference Committee, it is still important for you to call them now! Will you take the time to contact your legislators and simply say, "Please support the Senate budget amendment to expand Medicaid without delay! Virginians cannot wait."   If you are unsure of your legislators, click here to find out who your legislators are and how to contact them. If you know one of your legislators is a conferee, just click on his or her name above for contact information.   For everyone:  Will you also call Governor Bob McDonnell at 804-786-2211 with the same message?   After you call, will you ask three friends to call and urge our legislators and Governor McDonnell not to delay on Medicaid expansion? This is an excellent opportunity to take action on an issue that will affect hundreds of thousands of Virginians!   Thanks for all your hard work on this issue! 

Area Man Lobbies for Medicaid Expansion in Virginia

Icon February 11, 2013 - 14:30   BY JIM HALL and CHELYEN DAVIS / THE FREE LANCE–STAR http://news.fredericksburg.com/newsdesk/2013/02/08/area-man-lobbies-for-medicaid-expansion-in-virginia/ Jay Fuller, 63, lives alone in Caroline County. He earns less than $800 a month as a self-employed flooring contractor. He has health problems, but no insurance.Fuller counts himself among the thousands of Virginians who would be eligible for health insurance under a proposed expansion of the Medicaid program. He favors that expansion, and on Friday joined Virginia Organizing, an advocacy group, to lobby legislators in Richmond to approve it.  Fuller and others in his group delivered candy watches to legislators’ offices, as a reminder that time matters: If Virginia delays expanding Medicaid, it will lose federal money that would otherwise go for people’s health care. The group found mostly secretaries and legislative aides at the lawmakers’ offices. But in Del. Joe Johnson’s office, Fuller was encouraged. Johnson, a Democrat from Southwest Virginia, backs the expansion, since it would help many of his constituents, his aide said. Fuller is the type of person the Virginia Poverty Law Center had in mind when it said that an expanded Medicaid program would help low-income, uninsured adults, who “often work in the service and construction sectors,” and need help with chronic health conditions. “He is a great example of someone who is working hard and can’t afford insurance. This would help him out,” said Jill Hanken, health attorney for the Poverty Law Center.  Fuller said he’s worked for 40 years in the flooring business, installing tile, linoleum and carpet. He said he knows numerous other contractors, like himself, who don’t have insurance and are embarrassed to seek help. Like him, some have health problems and can’t afford the bills from a hospital visit.Fuller’s health problems began in 2010, when he was taken by ambulance to Mary Washington Hospital with a suspected stroke. “Darkness was coming to my eyes. My blood pressure was way out of whack,” he said. Since then, he’s learned to control his blood pressure with regular doctor visits and two medications. He also has diabetes, which he controls through diet, he said. Fuller gets help at the Community Health Center of the Rappahannock Region in Fredericksburg, where he qualifies for the sliding-scale price of $20 per visit. He gets his prescriptions at Walmart for $7 a month. “If I could get Medicaid, I can see any doctor,” he said. Fuller is ineligible for Medicaid under current rules. In Virginia, the federal/state program is reserved mostly for children, pregnant women, the disabled, some elderly and those in long-term care facilities.Low-income, childless adults such as Fuller are ineligible. Expansion would allow those who earn up to 138 percent of the federal poverty level, or about $15,400 per year, to join the program.  Fuller said he’s frustrated at the tone of the Medicaid debate. He feels like those who oppose the expansion portray those who support it as people who don’t work. He said he and his friends, are “hardworking people,” and he thinks the government would do better to spend some money to help them stay healthy, rather than see them with costly medical bills when a crisis hits. Fuller likened it to maintaining a car. It’s cheaper to change the oil than replace the engine, he said.

Senate to consider quicker decision on Medicaid

Icon February 7, 2013 - 14:44 February 7, 2013 BY MICHAEL MARTZ Richmond Times-Dispatch http://www.timesdispatch.com/news/state-regional/virginia-politics/general-assembly/senate-to-consider-quicker-decision-on-medicaid/article_aded10f5-7517-5faf-bffc-4b61b9721040.html The Virginia Senate is having second thoughts about waiting another year to decide whether to expand the state’s Medicaid program to hundreds of thousands of uninsured Virginians under the national Affordable Care Act. The Senate Finance Committee is expected to introduce an amendment to the state budget today that would allow expansion of Medicaid this year if the state succeeds in getting federal approval of changes to the program. Committee Chairman Walter A. Stosch, R-Henrico, said Wednesday that the committee is preparing language for the budget that would change a previous provision requiring General Assembly approval next year for the program to expand. Sen. Emmett W. Hanger Jr., R-Augusta, chairman of the finance subcommittee on health and human resources, called for the change after a presentation Wednesday by the McDonnell administration on progress in making program reforms. “The positives (of expansion) are beginning to significantly outweigh the potential concerns and negatives in my mind,” said Hanger, who called Medicaid expansion “the most important decision on our table in this session.” Gov. Bob McDonnell continues to resist the option of expanding Medicaid to 250,000 to 400,000 uninsured Virginians, but his administration helped make the case on Wednesday for not delaying the decision for another year. “If you delay, it puts us further behind,” said Secretary of Health and Human Resources Bill Hazel, who said he doubted the state would be ready to expand the program on Jan. 1 even if the assembly made the decision now. The stakes are high for Virginia, which stands to receive more than $23 billion in federal spending on the expanded program over the next nine years at a net cost to the state of $137.5 million, not including savings from pending reforms. Regardless of the decision, Virginians will pay an estimated $26.3 billion in federal taxes through 2022 to carry out the law, whether here or in states such as Ohio and Arizona, where Republican governors have announced plans to back Medicaid expansion. Lt. Gov. Bill Bolling cited both the economic benefits and the loss of Virginia tax dollars to other states in breaking with McDonnell last month to endorse Medicaid expansion if the state is able to reform the program. Delaying expansion after Jan. 1 would cost Virginia an estimated $5 million a day in federal spending and $400,000 a day in state-budget savings, argued a coalition of health care advocates at news conference Wednesday. “The bottom line is delaying Medicaid expansion becomes financially irresponsible for Virginia,” said Michael J. Cassidy, president/CEO of the Commonwealth Institute for Fiscal Analysis, which made the estimates. McDonnell and Republican legislators remain concerned, however, that the cost to Virginia would be much higher if the federal government, under pressure to reduce the budget deficit, scales back its financial commitment to the state. The Affordable Care Act commits the federal government to 100 percent of the cost in 2014 through 2016, and no less than 90 percent thereafter. Sen. Ryan T. McDougle, R-Hanover, pointed out that the cost to Virginia would rise by more than $1 billion a year if the state had to pay half, as it does for most Medicaid expenses now. Hazel said the state could follow the examples set by Ohio and Arizona by specifying that if federal support fell below 85 percent of the cost, the states could begin dropping people from Medicaid coverage. Stosch suggested the state could require a similar trigger for reforms, scaling back the program if expected cost savings and efficiencies aren’t realized. He also said Virginia could set up a “rainy day fund” to bank savings in the first five years to cover higher anticipated costs after 2018. The most difficult question for legislators may be in defining the changes they expect in Virginia’s Medicaid program. “What is meaningful reform and how much risk are you willing to take?” Hazel asked. “I know that we are not looking for a lot of risk for the commonwealth.” The answer is clearer in the Senate than in the House of Delegates, where the Appropriations Committee set out a much broader process for changing the entire program before the legislature would consider expansion. The Senate set out more specific reforms sought by the administration, which reported progress in getting federal support for the changes. For example, Hazel said the state and federal governments are working on a cost-sharing agreement on a pilot program for people who received both Medicaid and Medicare benefits that could save Virginia more than $22 million next year and $260 million by 2022. The Department of Health and Human Services also has issued guidance recently that would give states flexibility to fashion benefit packages for new Medicaid recipients that more closely resemble commercial insurance benefits and provide the ability to require participants to pay a share of the cost of care. The Centers for Medicare & Medicaid Services also has shown interest in Virginia’s request to consolidate administration of its six waiver programs for special populations into one. Hazel cautioned that working out the details of these reforms with the federal Medicaid agency could take months. “I can’t tell you how long it will take us to get there. They’re interested. They’re talking.” Hazel said McDonnell wants firm federal commitments for all of the changes necessary to control the delivery and cost of care for current Medicaid recipients as well as those who would become eligible under expansion. “He is very, very skeptical we will get them to his satisfaction,” Hazel said.

Ohio Governor Comes Out in Support of Medicaid Expansion

Icon February 5, 2013 - 02:50 February 4, 2013 By David Nather http://www.politico.com/story/2013/02/john-kasich-obamacares-biggest-red-state-catch-87143.html Conservative groups wanted to stop the march of Obamacare expansion at ground zero: the states.  But one of their best hopes just caved.   John Kasich, the fiercely conservative governor of Ohio, announced Monday that he’s going to expand Medicaid dramatically using federal money — a 180-degree turn from what conservative groups swore their allies in governors’ mansions would do when the Supreme Court gave them an out last year. That leaves Kasich, who built his political identity arguing for smaller government, at odds with the same movement conservatives who propelled him to victory in Ohio and have eyed him for a presidential run in 2016. “I think it’s definitely going to weaken him with the conservative base,” said Chris Littleton, the Ohio director for American Majority Action. “It’s not a good idea to expand your No. 1 budget item in the middle of this kind of instability. The conservative grass roots and average voters are not going to support this in any way, shape or form.” Tea party groups gave the decision a big thumbs down, a rare moment when they’ve been at odds with Kasich. “Medicaid is a broken, costly system that needs meaningful reform; expanding the system to include another 365,000 individuals is exactly the wrong policy for Ohio families,” said Nicole Kaeding, state policy manager for Americans for Prosperity. “Instead of trapping families in a system that doesn’t work, Gov. Kasich should devote his efforts and activities to forcing Columbus and Washington to pass badly needed reforms.” Kasich’s not alone. He’s joining four other Republican governors in accepting the expansion, though they’re still outnumbered by the nine GOP governors who are refusing to do it — including Bobby Jindal of Louisiana and Rick Perry of Texas — and others who are leaning against it. And now that Kasich has taken the plunge, some of Obamacare’s supporters hope others will follow. Topher Spiro of the liberal Center for American Progress says Kasich’s decision should be “influential” with other GOP governors. But Ohio tea party activists are frustrated to see another Republican governor — especially one with Kasich’s reputation — embracing what they see as just another government solution to a problem. “How can that be good for Ohio to have more people dependent on government?” asked Ted Stevenot, president of the Ohio Liberty Coalition. “How can it be good for us politically, economically? I just don’t see it.” Kasich says the decision will free up money to spend on mental health and other services — since the feds will pay for most of the expansion costs — and will keep everyone else’s health insurance premiums down because there won’t be so many uninsured people going to emergency rooms for their medical care. He’ll get a ton of money to do it — the federal government will pick up all of the costs of the newly eligible people for the first three years, and then slowly scale that back to 90 percent of the costs. Kasich also said he had gotten assurances from White House senior adviser Valerie Jarrett that the Obama administration might be willing to give Ohio some special flexibility for doing the Medicaid expansion, like letting the newly insured people get their coverage through the law’s health insurance exchange rather than through Medicaid. And local health care and business leaders have been pushing Kasich to do it. They say Ohio will save money in the long run and that it makes business sense to do it so community hospitals aren’t forced to close. Kasich seemed to buy that argument, saying rural hospitals could have faced “financial chaos” if he had refused to expand Medicaid because they no longer would get enough funds to cover the cost of treating uninsured patients. Read the entire article: http://www.politico.com/story/2013/02/john-kasich-obamacares-biggest-red-state-catch-87143.html#ixzz2JzJuef3S

Medicaid Expansion is a Good Deal for Women, and a Good Deal for Virginia

Icon February 4, 2013 - 21:07 February 4, 2013 The health care law known as the Affordable Care Act (ACA) makes important advances to provide millions of Americans with high-quality and affordable health care. Right now, Virginia has an important decision to make. The Supreme Court decision upholding the health care law allows states to decide whether or not to expand coverage through the Medicaid program. If Virginia implements this expansion now, it will dramatically reduce the number of uninsured Virginians, garner an extraordinary amount of federal support and ensure a smarter use of Virginia’s healthcare dollars. Delaying Medicaid expansion will hurt Virginians. Up to 169,000 currently uninsured women would be eligible for coverage through an expansion of Virginia’s Medicaid program. When combined with other reforms in the ACA, this coverage expansion would reduce uninsurance among women in Virginia from 17.4 percent to 4.4 percent. Hardworking women and men in Virginia deserve the financial security of having health coverage. Yet state budgets are strained, and while the overall fiscal outlook is improving, most states are only beginning to feel relief from the recession. That’s why this opportunity to expand Medicaid coverage is so important. The federal government will pick up 100 percent of the costs related to expanded coverage for the first three years, and at least 90 percent of costs after that. Governors and state legislators across the country—on all sides of the political spectrum—have done the math and come to the same conclusion: it’s too good a deal to turn down. By providing affordable health insurance, Medicaid plays an important role in improving low-income women’s economic security.  At the same time, Medicaid supports millions of jobs that women hold across the country.  In Virginia, Medicaid currently supports an estimated 48,313 health sector jobs held by women. Women covered through Medicaid will receive a comprehensive set of health benefits, such as mammograms, preventive health screenings, and treatment for chronic conditions.  In addition, women and their families will enjoy greater economic security—people with Medicaid coverage are less likely to ignore other bills or borrow money to pay medical expenses than people without health coverage.  When women have health insurance, the entire family can better manage its health—for example, children can get their asthma medications, and moms can work with their doctors to manage their high blood pressure.    Health coverage for women and families is an effective use of healthcare dollars. On the other hand, Virginians are already paying for individuals without coverage through the higher rates hospitals and clinics must charge people with health coverage to cover costs incurred by those without it. This cost-shifting creates a “hidden tax” that all of us pay, amounting to an additional $1,100 per family, on average, in healthcare premiums. That’s why expanding coverage through Medicaid, with unprecedented federal money, is simply a smarter use of our healthcare dollars. Virginia should seize this opportunity to provide comprehensive insurance coverage that helps people get appropriate treatment before they get too sick, and diverts people from high-cost emergency rooms towards more cost-effective care. Virginia must make wise investments to grow the economy, while helping hardworking women and their families get health coverage.  Expanding health coverage through Medicaid is a sensible approach to improving access to care, a good deal for Virginia, and a smarter use of healthcare funds. Leaving millions of federal dollars on the table—and so many women in Virginia without health coverage—would be foolish.

Lt. Governor Bill Bolling Endorses Medicaid Expansion

Icon January 31, 2013 - 20:52 January 31, 2013 Today, Lt. Governor Bill Bolling indicated his support of Medicaid expansion if the federal government will grant Virginia waivers to pursue reforms. Lt. Governor Bolling sent a letter to House of Delegates and Senate leadership today with his thoughts on the expansion. The Lt. Governor states, "Having spent a career working on health policy in Virginia, I am confident that there is no state better prepared to move forward on both reform and coverage expansion than the Commonwealth."  He calls the decision "straightforward" and says, "we should move forward now, just as we did 13 years ago [with the implementation of FAMIS], with the confidence that we will implement the program thoughtfully, that we will manage it prudently and that we will have a stronger and more prosperous state as a result."  You can read the full letter from Lt. Governor Bolling by clicking here. 

Medicaid Expansion: A Win for All Virginians

Icon January 30, 2013 - 21:02 Covering the poor while growing the economy    Date published: 1/30/2013 http://fredericksburg.com/News/FLS/2013/012013/01302013/1359563581fls By Dr. Christopher Lillis and Jill Hanken GIVEN a roomful of people, most people can’t tell by looking which ones don’t have health insurance. But the emergency-room doctor knows who they are. They’re the patients who show up when they’re too sick to ignore their medical problem any longer. When they leave with their prescriptions, they probably won’t fill them, because they can’t afford to. The legal-aid attorney knows them, too. They are low-wage workers or people who lost their insurance when they lost their jobs. They broke a leg, or developed cancer, or went into heart failure that required hospitalization. Now, they’re seeking relief from constant calls trying to collect on impossibly high bills for the care that saved their lives. More than 1 million Virginians are uninsured—one in eight citizens of the commonwealth. Virginia now has a chance to bring 400,000 of them into the Medicaid program. The federal government will foot the bill for those newly eligible, at 100 percent for the first three years and no less than 90 percent after that Who would benefit? All of us. People whose annual income is within 138 percent of the federal poverty line—about $15,400 per year for an individual and $32,000 for a family of four—would be covered. They would have access to care that most take for granted: yearly check-ups, prescriptions, cancer screenings, and medical intervention at an early, treatable stage. Regular primary care with an emphasis on prevention and healthy lifestyles will help them be more productive employees and more effective parents, at a lower overall cost. The rest of us would benefit, too. After all, we are already paying for the care of the uninsured. Our premiums are higher because we subsidize what the uninsured cannot pay. Our federal, state, and local taxes also support indigent care. By extending Medicaid, we would ensure that Virginians’ federal tax dollars would come back to help Virginia’s low-income workers and families, instead of paying for expansions in other states. ECONOMY WOULD BENEFIT Virginia’s economy will benefit, too. After comprehensive study, Virginia’s Medicaid agency concluded that over a 10-year period, the commonwealth would receive more than $20 billion in federal funding, while spending less than $150 million for the state’s portion of the expansion. That money will pay health-care providers, hospitals, technicians, medical suppliers—well-paying jobs that will generate taxes and spending in Virginia communities. Several sources—notably, the Virginia Senate Finance Committee and Chmura Economics & Analytics—project that 30,000 new jobs will be created and supported by the large infusion of federal funding. When the costs, savings and economic impacts are fully evaluated, several studies show that that the expansion is a major benefit to Virginia that pays for itself. Projected outcomes such as these have drawn a diverse array of supporters. The 3,361-member Virginia Chapter of the American College of Physicians—made up of internal medicine physicians and medical students—endorses the expansion. “Extending Medicaid coverage to Virginia’s low-income uninsured will improve health status and quality of life,” the chapter concluded in its recent “Report from Virginia’s Internal Medicine Physician Specialists: How Will the Medicaid Expansion Benefit Virginia?” Without the expansion, “[W]e will be leaving our poorest residents with no other way to get coverage—resulting in poorer health outcomes for them, more uncompensated care for hospitals and physicians to take care of , more cost-shifting for the rest of us, and ultimately, higher cost to the Commonwealth,” the internists concluded. COVERAGE FOR ALL On Jan. 16, Healthcare for All Virginians, a 50-plus-member coalition of consumer groups, hospitals and other health-care providers, held a press conference to call attention to the Medicaid expansion opportunity. There, Wayne Hamlett, 61, told his story. He was laid off in 2008 after more than three decades working in the auto-parts business. While he was job hunting, he went to the Fan Free Clinic in Richmond for insulin for his diabetes—a lucky break, because free clinics are often not able to meet the demand for their services. Hamlett eventually found a job with health insurance, but dropped the coverage when the premiums reached an unaffordable $460 a month. Then he needed heart surgery. Again, he was fortunate—the Bon Secours Health System treated him through its charity program. But his employer reduced him to 22 hours a week, so now he’s back at the Fan Free Clinic for insulin and other medications. “The people who want to work, who’re willing to work, who love to work—if the government could do something to help them out with health care and insurance, that would be awesome,” Hamlett said. For the sake of Hamlett and hundreds of thousands of others, the General Assembly should accept the federal offer, expand Medicaid, and extend health coverage to Virginia’s low-income uninsured. The expansion is compassionate, good stewardship of tax money and good business sense. Dr. Christopher Lillis is an internal medicine specialist who practices in Fredericksburg. Jill Hanken is the health-law attorney for the Virginia Poverty Law Center, which advocates for low-income Virginians.