Health Care

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:

Marketplace Offers Affordable Health Coverage Across Virginia

Icon October 3, 2013 - 16:36 Leading up to open enrollment in the new market for private health insurance, which began yesterday and runs through March 31, 2014, there was a lot of unfounded speculation that the insurance plans would be shockingly expensive. But the rates are in, the Marketplace is open, and the comprehensive coverage offered actually costs less than expected. Nationally, rates are 16 percent lower than originally predicted by the Congressional Budget Office. And many consumers can get tax credits to lower the sticker price and make the coverage even more affordable. Tax credits are available to people with incomes between 100 percent and 400 percent of the federal poverty level — about $19,530 and $78,120, respectively, for a family of three. Factoring in the tax credits, nearly 240,000 uninsured Virginians will be able to get the lowest cost Bronze plan at no monthly cost or a more comprehensive Silver plan for less than $75 per month through the Marketplace, according to a recent report by Credit Suisse. And in Virginia, consumers have a wide variety of affordable, comprehensive plans available to them. Depending on where they live, consumers have from 27 to 68 plans to choose from in the Marketplace, according to data released by the U.S. Department of Health and Human Services. With the Marketplace open and financial assistance available, it’s time to start shopping for quality, affordable coverage. —Massey Whorley, Senior Policy Analyst - See more by clicking here. 

Health Insurance Marketplace to Open Tomorrow

Icon September 30, 2013 - 19:03 It’s finally here. Tomorrow, October 1, the Affordable Care Act’s (ACA) new Health Insurance Marketplace will open for enrollment for those who are uninsured or those who currently pay too much for their insurance. You have until December 15 to sign up for your insurance to take effect on January 1, 2014, so there is plenty of time for you to explore your options and talk to your family about the right plan for you.     The Kaiser Family Foundation has a great cartoon you can watch that helps better explain the Affordable Care Act and how the Health Insurance Marketplace will work. You can find that by clicking here.   If you watch the video, you’ll notice that there are some people who will be left out of the ACA and unable to access insurance because some states have chosen not to expand Medicaid. Virginia is one of the states that still needs to expand. But, there is hope and you can help!   Virginia’s Medicaid Innovation and Reform Commission (MIRC), the body responsible for reforming and expanding Medicaid, will be meeting again on Tuesday, October 15. They need to hear from you! If you are able to attend the meeting, it will be held at the General Assembly Building in Richmond in House Room D at 1 p.m. The purpose of that meeting is to hear from the public, so it is important that people attend. If you are unable to attend the meeting, please consider making a comment in support of Medicaid expansion.Please click here to be taken MIRC’s public comment submission page.   By now, you’ve likely heard that the government is going to shut down at midnight (September 30). A government shut down will not affect the opening of the Health Insurance Marketplace. Funding for the ACA comes from sources not affected by the shutdown.   As more information becomes available, we will post to our website, Facebook page, and Twitter. Later this week, Enroll Virginia! will have more information on their website about how to get help signing up for insurance in the new Marketplace.   Open enrollment closes on March 31, 2014 and there are some rules about when you can enroll and when coverage will begin. Please be sure to visit for more information on enrollment dates and coverage start dates.   Don’t forget to share this information with your family and friends that might need to get health insurance coverage!

Explanation of New Health Plan Draws a Crowd

Icon September 24, 2013 - 14:04 By Kate Thisdell New health insurance marketplaces will be open for business in just one week.  On Oct. 1, the new federal marketplace goes live online as a virtual “supermarket” for shopping for health insurance policies. You’ll be able to compare policies under different companies in an apples-to-apples manner, said Dr. Chris Lillis, a Fredericksburg internist who spoke to a standing-room only crowd at a forum Monday evening on the Affordable Care Act. “For the first time, policies will be standardized,” Lillis said at the informational meeting held at the Central Rappahannock Regional Library in Fredericksburg. “You won’t have to read the fine print to see what’s covered and what’s not.” But while health insurance plans must cover certain things—such as preventive care, prescriptions, hospital stays, mental health care and blood tests—picking a level of care for an individual leaves many with questions. The marketplace isn’t for everyone, explained Lillis and Bill Botts, the new health care navigator for the city and 16 counties. He is tasked with explaining the law and how people should get insurance under it. Botts, a longtime attorney with Rappahannock Legal Services, and a team of volunteers, will open a Fredericksburg office on Oct. 1 as well, and is taking appointments. He encourages everyone to research options at, and not to rush a decision. The federal exchange is for people who don’t have insurance and can’t get it through work, can’t afford private insurance plans and don’t qualify for Medicare or Medicaid. Virginia chose not to have a state-run exchange. You don’t need the exchange if you’re eligible for Medicare or Medicaid; if you get insurance through your employer; if you’re paying for a private insurance plan; or if you’re in Tricare or veterans health programs. Tuesday’s forum, hosted by Virginia Organizing, focused on two groups—the uninsured and small-business owners, likely the two most affected, Lillis said. One in 7 Americans have no insurance right now, said Lillis, also a columnist with The Free Lance–Star. The Affordable Care Act is expected to put a “good dent” in the 40 million to 45 million uninsured, though it won’t help everyone at the start, he said. The lowest income bracket will still be covered by Medicaid; an expansion of the program is under debate by legislators. Lillis said a large gap will remain, leaving millions of low-income adults with no affordable options in the meantime. For those who make 100 percent to 400 percent of the federal poverty level, coverage can be purchased through the exchange and, depending upon income levels, they will receive a subsidy from the government. That tax credit, which will be based on current income levels and will be paid directly to the insurance companies, can drastically reduce a person’s premiums. For example, a family of four that makes $50,000 could choose a plan that costs $924 per month. Tax credits would reduce the cost to $280 per month. Any changes would be reconciled in the next year’s tax filings. But Lillis and Botts said they couldn’t go through every example at the forum—that’s what the health care navigator is for. During the question-and-answer part of the two-hour forum, Lillis said that every individual’s circumstance will be different from the next, and even though the exchange goes live next week, it’s open for months. Coverage begins on Jan. 1, 2014, and there’s a 15-day waiting period after a premium is paid before a policy starts. If you purchase by Dec. 15, your coverage will go into effect at the new year. But that’s not the final deadline. The exchange will be open for six months this year, meaning March 21 is the last day to sign up until open enrollment begins again, in October 2014.