Health Care

Let's Talk Turkey!

Icon November 26, 2013 - 18:21 Today, ProgressVA named Virginia’s Speaker of the House, Bill Howell, the “Turkey of the Year.” This award is given to a politician who uses his or her power for personal political agendas instead of focusing on what is best for all Virginians. The award for Speaker Howell is timely for the Thanksgiving holiday.    Speaker Howell has refused to expand Medicaid due to his political beliefs, in spite of the fact that expansion will create jobs and opportunities for Virginians, provide health care to low-income, working people, and be a boost to our economy. Hundreds of thousands of Virginians will fall into the “Bill Howell Medicaid Gap,” meaning they are too poor to qualify for subsidies and credits to pay for health care on the Health Insurance Marketplace, but are not poor enough to currently qualify for Medicaid in Virginia.   Something about this whole thing is certainly “fowl” and we hope that Speaker Howell will reconsider his position on expansion since economists and policy experts agree this is right for Virginia.   Will you take a few minutes and call Speaker Howell at 540-371-1612 and tell him that we need Medicaid expansion in Virginia? Virginians can’t afford to NOT expand!   Thank you for raising your voice for the thousands of people who need health care in Virginia! For more information about Medicaid expansion, visit or click here to view our flyer with facts about expansion.   Sincerely,   Sandra A. Cook Chairperson

Study: Vast majority will be better off under ACA

Icon November 22, 2013 - 14:29 By Chelyen Davis Published by The Free Lance-Star on Novemeber 22, 2013 A new study says more than three-quarters of the 403,000 Virginians younger than 65 with individual health insurance coverage could qualify for some level of federal tax subsidy by buying health insurance through the federal marketplace. But that leaves about 83,000 Virginians who might find their existing insurance canceled who won’t qualify for the subsidy help. The data come from a Families USA report released Tuesday that was intended to demonstrate how relatively few people are affected by the cancellation of their individual insurance policies by insurance companies to comply with Affordable Care Act standards. Families USA is a group that’s been advocating for the federal health care law. Little hard data is available on how many people have had their policies canceled, although the issue has been in the headlines in recent weeks because it belies the president’s oft-repeated promise that if people liked their insurance coverage, they could keep it. On a press call Thursday, Families USA Director Ron Pollack said his group estimates that only 0.6 percent of the non-elderly—i.e., people younger than 65—population is at risk of losing current coverage without being eligible for financial help (the tax subsidies created by the ACA for people making less than 400 percent of the poverty level) to pay insurance premiums. That’s still about 1.5 million people, Pollack said, 83,000 of them in Virginia. “And that’s not trivial. I don’t in any way suggest we shouldn’t be concerned about that,” Pollack said. But, he added, “that number is a tiny fraction” of people who ACA backers say will get better coverage because of the federal law’s changes to the insurance system. “Frankly, while obviously this is a concern for anyone receiving a termination notice, especially if they have not yet found an alternative that is at least as good I believe that this concern has been blown significantly out of perspective in terms of the totality of the Affordable Care Act,” Pollack said. “The overwhelming majority of people with private individual health insurance today will soon be able to receive better coverage and pay lower premiums due to the Affordable Care Act. As a result their improved health coverage will become much more affordable.” The Families USA study says that 403,000 Virginians younger than 65 have individual health insurance plans. Of those, the report says, 320,000, or 79 percent, make less than 400 percent of the poverty level, which means they could qualify for some level of federal tax subsidy to help pay insurance premiums. Of the remainder, 0.4 percent have individual coverage and are expected to retain it for more than a year. “The individual insurance market is often thought of as the Wild, Wild West of health insurance,” Pollack said. “It is an extraordinarily volatile market.” Pollack said subsidies should make policies more affordable for many people, even if the actual price of the new insurance plans is higher because the ACA requires new policies to cover more things. “There’s no question that when people get better coverage, it is likely to mean they are going to pay somewhat higher premiums. You don’t get anything for nothing,” Pollack said. “It does have a tendency to increase premiums when you provide better coverage. [Subsidies] can more than make up for the increase in premium cost because you’re getting better coverage.” Pollack was asked if his report’s numbers reflect the “coverage gap” experienced by people who make below the federal poverty level. In states like Virginia that have not expanded Medicaid eligibility, childless adults below the federal poverty level not only aren’t eligible for Medicaid, they’re also not eligible for federal tax subsidies to buy health care. While those are “the people at greatest risk and harm” from not getting insurance coverage, Pollack said, they also tend not to have purchased individual insurance coverage because they can’t afford it. As a result, he said, those in that coverage gap don’t add significantly to his group’s estimate of people who would be affected by canceled plans. Last week President Barack Obama publicly urged insurance companies to temporarily renew old insurance policies for the customers who’ve had their insurance canceled recently. Since then, Virginia’s Bureau of Insurance has been analyzing whether it can comply with that. In a statement Wednesday, the BOI said it is “unclear whether the Bureau has the authority” to fully implement the president’s recommendation. But, the statement said, the BOI can permit insurance companies to give customers early renewal of existing insurance policies so that coverage extends for another year. The board is thus encouraging insurance providers to offer those extensions through the end of 2014, and promising to expedite approval of any rate revisions necessary.

Tell Delegate Landes to Expand Va. Medicaid

Icon November 12, 2013 - 13:04 By Rebecca Foster Published in The Daily Progress, November 7, 2013 The federal government is subsidizing the bill to expand Medicaid; expanding Medicaid will actually cost the state less than at the present moment. Virginia’s federal tax dollars are already paying for expansion, so it only seems right take advantage of what we are paying for. After all, that is the fiscally responsible thing to do, isn’t it? While I do not see any valid reasons not to expand Medicaid, there are countless reasons why we should. Reliable access to health care will make a stronger, more productive workforce; healthier children, who will do better in school; and more efficient use of the emergency rooms and resources that uninsured people currently use for standard health care. Del. Steve Landes, who represents my part of Albemarle County, is on the Medicaid Reform and Innovation Commission. He strongly opposes Medicaid expansion, claiming that federal funding will run out and Virginia will be left with an expensive problem to solve. But we have been assured that federal funding will stay at the same level through 2016 and then be reduced by a few percentage points in the following years. The low percentage that the state will be required to pay will be offset by the decrease in uncompensated care costs, the decline in the death rate of working citizens, and the enhanced productivity of a healthy workforce. Please get in touch with Delegate Landes, and ask him to do what is right for all Virginians. You can contact Delegate Landes at 540-255-5335. 

Better Health = A Better Community

Icon November 12, 2013 - 12:19 By Pat Young Published in the Roanoke Times, November 7, 2013 Healthy Roanoke Valley is a partnership of more than 50 public and private organizations, academic institutions, community and government leaders who are working to improve the health of those living in the Roanoke Valley. Our mission is to mobilize community resources to improve access to care, coordination of services and to promote a culture of wellness. Our focus is on the underserved populations in the region, including the low-income, uninsured and underinsured. In the Roanoke Metropolitan Statistical Area, including the counties of Botetourt, Craig, Franklin and Roanoke and the cities of Salem and Roanoke, more than 32,000 residents are uninsured. According to a recent Roanoke Community Health Needs Assessment, the uninsured in the valley are more likely to lack access to primary care, mental health and dental services and are unable to pay for these services out-of-pocket. They are more likely to use hospital emergency departments for minor injuries or illnesses that do not require emergency evaluation or treatment. Often they are unable to navigate the health care system, have limited health literacy and have poor health outcomes due to lack of preventive care and chronic disease management. By expanding Medicaid eligibility in Virginia up to 138 percent of the federal poverty level, approximately 400,000 uninsured Virginians would become eligible for health care. Just to put it in perspective, this would include individuals who earn up to $15,800, or families of four up to $32,500 annually. The majority of people who would be newly eligible for Medicaid coverage are adults working in the state’s five largest employment sectors: tourism; retail trade; educational, health and social services; construction; and professional, scientific, management, administrative and waste management services. In the Roanoke Valley, Medicaid expansion would impact 41 percent of the uninsured or more than 13,000 individuals. On behalf of our many partners, Healthy Roanoke Valley has reached out to the Medicaid Innovation and Reform Commission members in support of Medicaid expansion in Virginia. Expansion will ensure those we serve are able to get quality, consistent care at a lower cost, resulting in improved health for our community as a whole. Medicaid expansion impacts our region and the state’s economic health by creating a healthier, more productive workforce, leading to growth in the state economy and a vibrant future for all our citizens.

47,000 Reasons to Expand Medicaid

Icon November 11, 2013 - 14:27 Published by the Virginian-Pilot on November 7, 2013 The financial case for states to expand Medicaid, as provided through the 2010 Affordable Care Act, has been well established. Over the next five years, Virginians will pay $10 billion in new federal taxes associated with implementation of the health care and insurance industry overhaul. The federal government has offered to send nearly all of that money back to the commonwealth if state leaders expand the eligibility criteria for lower-income people to receive health insurance coverage through Medicaid. If the state doesn't expand Medicaid eligibility, Virginia's taxpayers will see their money go to other states, where it will be used to create jobs and improve the health of poorer residents. Twenty-five states have agreed to expand the program. From a fiscal sense, rejecting the return of Virginia tax dollars to Virginia makes no sense. Based on Tuesday's election results, more Virginians appear to recognize as much, given that they elected as their next governor Terry McAuliffe, a Democrat who campaigned on a pledge to expand Medicaid. The financial cost of refusing to expand Medicaid is overshadowed by the human toll. As The Pilot's Amy Jeter recently reported, Virginia's intransigence ensures that about 47,000 people here in South Hampton Roads will continue to be denied coverage. They earn less than 138 percent of the federal poverty level - about $15,415 for one person, and $31,809 for a family of four - making them ineligible to receive the subsidies better-paid people can receive to buy insurance. Virginia has long held an embarrassing place among the stingiest states for Medicaid spending. It ranks No. 46, according to a study published earlier this year by the state Joint Legislative Audit and Review Commission. Virginia's current eligibility criteria restricts Medicaid only to pregnant women, children, the elderly and disabled and families living in abject poverty. A family of four with an annual household income greater than $7,146 earns too much to qualify. Moreover, Census data show 70 percent of Virginia's uninsured live in households where at least one adult works. Opponents of expanding Medicaid have alternated between claims that the federal government will never live up to its pledge to cover the statutorily designated minimum of 90 percent of costs in 2021, and that Virginia's Medicaid costs are already too high. Neither claim is based in reality. Virginia, for example, relies on the federal government to abide by federal law on all kinds of matters related to spending, including transportation and education. Gov. Bob McDonnell and other elected officials aren't rejecting federal funds for those initiatives because of a sudden anxiety over the national debt. Medicaid should be no different. Meanwhile, opponents have managed to conflate two separate programs within the umbrella of Medicaid to stir anxiety over the state's costs. Critical care coverage is provided to the disabled and elderly, who account for one-third of the people covered by Medicaid in Virginia, but two-thirds of the spending. Lawmakers have shown little stomach for reining in those costs. The remaining two-thirds of Virginians on Medicaid live in extreme poverty, or are low-income pregnant women and children. Their managed health care represents about one-third of Virginia's spending on Medicaid. This is the portion of Medicaid that the ACA seeks to expand and fully fund for the next three years through federal tax dollars that Virginians already will pay. It is also the most efficient form of Medicaid, and expansion is expected to provide coverage to close to 250,000 uninsured Virginians, the majority of them working folks.Their plight, like the obvious math that would relieve it, remains ignored by the current governor and his political allies in Richmond.

Medicaid is Far From Broken: New Report

Icon October 15, 2013 - 20:19 New Report Shows Medicaid Is Far From Broken Critical Health Insurance Should Be Offered to More Virginians  RICHMOND, VA - Virginia's Medicaid program isn't the broken, out-of-control system that its opponents portray, according to new analysis released today by The Commonwealth Institute for Fiscal Analysis, an independent fiscal and economic policy organization in Richmond. "Despite the strong rhetoric of those opposed to expansion, the fact is Medicaid is an efficient insurance program that connects people with the health care they need to stay healthy and productive," says Michael Cassidy, President and CEO of The Commonwealth Institute. "And lawmakers should expand coverage options to get hard-working Virginians the help they need."Among the report's key findings: Medicaid coverage is efficient. It costs much less to cover people of similar health status with Medicaid than private insurance. Medicaid costs 29 percent less for children and 20 percent less for adults than private insurance.  Growth in Virginia Medicaid spending is largely due to the steady rise of health care costs nationwide and greater use of services. These factors account for 66 percent of the growth in costs since 1990. Medicaid enrollment has more than tripled since 1990, but that accounts for just 24 percent of spending growth and also includes enrollment increases from three recessions. Physicians are accepting new patients. Contrary to what many critics assert, most doctors accept patients with Medicaid insurance - about 76 percent. The share of doctors accepting new Medicaid patients is nearly the same as the share who are accepting new patients with private insurance or Medicare. And the Affordable Care Act gives primary care physicians a strong incentive to accept new Medicaid patients right now because it increases reimbursement rates for Medicaid through 2014. Medicaid coverage improves health. Gaining access to health coverage means that people can get the routine care they need before an inexpensive condition becomes a costly emergency or an expensive chronic illness. Compared to people without insurance, people with Medicaid are 25 percent more likely to report that their health is "good" or "excellent."  Expanding Medicaid can have significant long-term benefits, including lower overall death rates. In states that expanded Medicaid coverage between 2000 and 2005, the overall death rate declined 6 percent compared to neighboring states that did not expand coverage. Expansion would cover hundreds of thousands, but if the money stops, so does expansion. Providing Medicaid coverage to nearly 400,000 Virginians without health insurance is a great deal because the federal government will pay 100 percent of the cost through 2016 and no less than 90 percent after that. During the 2013 General Assembly session, Virginia lawmakers took the smart step to authorize an automatic end to the expansion if the federal commitment is ever reduced.  The full report, Medicaid Is Far From Broken, is available here. 

Medicaid Expansion Needs Your Help!

Icon October 9, 2013 - 17:09 The Affordable Care Act’s Health Insurance Marketplace is open for enrollment, but some people will be left out in the cold if Virginia fails to expand Medicaid. Next week, the Medicaid Innovation and Reform Commission (MIRC) will hear public comments about Medicaid expansion. There are three opportunities for you to help make sure Medicaid is expanded to 400,000 low-income Virginians.   1.     Make a comment on the public comment website of MIRC. Click here to be taken directly to their public comment website. They want individual letters, so write from your heart and make your opinion known. For some facts about Medicaid expansion, please click here to view our flyer.   2.     Sign our petition to make sure Medicaid is expanded in Virginia. We will be delivering this petition soon, so make sure you pass it along to your friends and family.   3.     Show up! The MIRC is holding a public hearing on Tuesday, October 15 at 1 p.m. (you will want to come early for a seat and an opportunity to speak). The Commission will also meet on Monday, October 21 at 1 p.m.  Both of these meetings will be at the General Assembly Building in Richmond in House Room D.  The physical address for the building is 1000 Bank Street, Richmond, VA 23219.   What can you commit to? Every effort you make helps Virginians get closer to Medicaid expansion—a program that is good for people, good for the hospitals, good for communities, and good for our economy.

Affordable Care Act: Newest Tool in Fight Against Breast Cancer

Icon October 8, 2013 - 13:50 By Alison Burns (10/08/13) RICHMOND, Va. - October is National Breast Cancer Awareness Month, and this year's event marks a major shift for women's ability to access the health care they need. Matt Schafer, state government relations director for the American Cancer Society's Cancer Action Network, pointed out that under the Affordable Care Act, women cannot be denied coverage because of preexisting conditions such as breast cancer. "The health-care law also requires health plans to cover annual preventive mammograms for women starting at age 40," Schafer said. "It prohibits lifetime dollar limits on coverage, and it also restricts the amount of out-of-pocket costs. And for an organization like the American Cancer Society, that's focused on finding a cure for this disease, nothing can be better." Education on prevention, earlier detection and better treatment options have all helped the five-year survival rate for breast cancer to climb to around 98 percent. According to Schafer, more improvements are expected as more women are able to access affordable health care and get regular check-ups and treatment if needed. "We've learned a lot about cancer. We've learned a lot about preventing it. We've learned a lot about treating it, but the one challenge we've encountered is cost," he said. "And the peace of mind that women are going to have looking into the next year; they can spend more time focusing on getting healthy, and not worrying about their life savings." Each year in Virginia, there are more than 6000 new cases diagnosed and around 1100 women in the state die from breast cancer. More information is at     Click here to view this story on the Public News Service RSS site and access an audio version of this and other stories: