Category Archives: Press

Medicaid expansion explained best through irony

From – we couldn’t improve on this, so here it is in its entirety [note: video is from HBO, so NSFW for language]:

John Oliver wants you to know how important state elections are, even if you don’t live in one of the states set to hold gubernatorial and legislature elections this week.

“There are American lives at stake here,” he said on his late-night show on Sunday. “A number of these elections could determine whether hundreds of thousands of people remain in or even fall into what’s known as the Medicaid gap.”

Under Obamacare, the federal government was supposed to subsidize health insurance for people above 138 percent of the poverty level. Anyone below that was supposed to be eligible for Medicaid. If that required states to expand Medicaid, the federal government would pay for it: The first few years, the federal government would cover the entire cost of the expansion. Over time, the federal government’s payments would be phased down to 90 percent of the cost, where it would remain. (To get a sense of how good of a deal that is, the federal government typically paid for about 57 percent of a state’s entire Medicaid program before Obamacare.)

At first, the Medicaid expansion was essentially mandatory under Obamacare. But in 2012, the Supreme Court ruled that the federal government was acting in a coercive manner, and the expansion was made voluntary, so states could decide for themselves if they wanted to expand the program.

Many states — notably Texas and Florida — have so far opted not to. These states don’t pay for Medicaid for individual adults unless that person is below 44 percent of the federal poverty level. That means individual adults in these states living between 44 percent and 100 percent of the federal poverty level can get less of a subsidy on his or her health insurance than someone living above poverty and eligible for subsidies from Obamacare’s insurance marketplaces.

The Medicaid coverage gap.
Kaiser Family Foundation

“Twenty states have so far declined to expand Medicaid, leaving over 3 million people in the Medicaid gap — people in the illogical situation of not making enough money to receive government assistance,” Oliver said, referencing a Kaiser Family Foundation report.

This year, two state elections could help decide the fate of the Medicaid program. In Virginia, the state legislature, which is the main hurdle toward expanding Medicaid, is being voted on. And in Kentucky, Republican gubernatorial candidate Matt Bevin earliervowed to undo the state’s existing expansion if he wins.

These kinds of state decisions are why Tuesday’s election and others like it seriously matter, even if they don’t get as much attention from the media as a whole. “So on Tuesday, even if you don’t live in a state holding an election, spare a thought for the people who do,” Oliver said, “because the results may ultimately affect the health of half a million people.”

Medicare 50th Anniversary Could Be Bigger Win for Virginians

Medicare-Medicaid 50th anniversary banner imageOn July 30, 1965, President Lyndon B. Johnson, as part of his war on poverty, signed the amendment to the Social Security Act that created Medicare and Medicaid. In the 50 years since, millions of Americans have gotten access to healthcare through both programs, helping keep them healthy members of their communities. Because Medicaid eligibility differs from state to state and Virginia has not taken advantage of the opportunity to expand eligibility, there is still work to do to close the coverage gap, currently making quality, affordable healthcare out of reach for up to 400,000 Virginians.

Virginia Consumer Voices for Healthcare is supporting a 50th Anniversary Celebration of Medicare and Medicaid on Wednesday, July 29 from 5 to 7pm at Grandy Village Learning Center, 2971 Kimball Loop, Norfolk, VA and Thursday, July 30, from 12 to 2pm at the Hampton Senior Center, 3501 Kecoughtan Rd., Hampton, VA. Both events will feature US Dept. of Health & Human Services Region 3 Director Joanne Grossi, along with a Coverage to Care panel discussion, and information on 2016 Medicare & Affordable Care enrollment updates.

Some quick facts about how Medicaid expansion would positively impact Virginia:

  • $1.64B in coverage funding would come to Virginia through 2022 (and the Federal government will continue to fund the coverage at 90% of costs thereafter)
  • Medicaid expansion would add 20,000 jobs to the Virginia economy
  • 25,200 military veterans or their families would be able to access care they cannot get through the Veteran’s Administration

In the 50 years that the Medicare and Medicaid programs have been in existence, the federal government has honored its commitment to Medicaid funding for all 50 states. The states themselves must elect to expand Medicaid, however, in order to cover uninsured people who don’t earn enough money to get tax credits to buy health insurance on the state or federal exchanges. Since Virginia’s legislature has not opted to take the Federal money to provide coverage, many of Virginia’s lowest income residents are locked out of access to quality, affordable healthcare and putting pressure on hospital emergency rooms and safety-net clinics to provide care.

Virginia Consumer Voices works to build and sustain a broad-based consumer-focused coalition which includes patients, community and religious organizations, small businesses, organized labor, community health centers, and advocacy organizations to support the expansion and improvement of health care in Virginia. Given our mission, we’d really like to see Virginia close the gap by expanding Medicaid in this 50th anniversary year.

Virginia Legislature to Decide on Medicaid Expansion


ARLINGTON, Va. — The patient had been managing his high blood pressure with medicine prescribed by his doctor until he lost his job and his insurance. As a childless adult, he did not qualify for Medicaid under Virginia's formula, so he cut his medications in half to extend his supply.

What happened next is one example of why the legislature's upcoming vote on revising Medicaid qualifications matters so much to so many.

The patient “had a severe headache and was taken to the emergency room,” said Dr. Basim Khan. “He had suffered a stroke." The stroke left him paralyzed, thereby qualifying him for Medicaid. The state is now picking up half of his Medicaid tab.

Khan, a physician at Alexandria's Neighborhood Health Services, Inc. a clinic in Arlington, VA, said he sees many cases like this–people who make just enough money to be above Virginia's threshold to trigger Medicaid assistance, but not enough to afford health care insurance.

Khan says his clinic serves 13,000 patients a year, 80 percent of whom are uninsured. Another 150,000 uninsured patients attend clinics in nearby counties.

"By and large, these patients are the working poor. They work low-wage jobs, driving taxis, working in restaurants or fast food chains, working in department stores or other small businesses. They make a little bit of money but they don't get insurance and they certainly don't have the money to purchase it," Khan said.

Latino Virginians top the list of the state's uninsured, according to Deshundra Jefferson of Virginia New Majority. Although they represent only 8 percent of the state's population, Latinos represent 33 percent of its uninsured, followed by African and Asian Americans, each at 17 percent, and European Americans at 11 percent.

Jefferson and Khan argued the case for expanding Virginia's Medicaid formula at a recent convening of ethnic media hosted by the Virginia Interfaith Center for Public Policy. Estimates are that Medicaid expansion could put health care within reach of 400,000 uninsured Virginians.

Revising the Medicaid formula is now part of a larger partisan debate in the state legislature over multiple issues, including increased transportation funding and automatic restoration of voting rights for non-violent ex-felons.

The partisan vote count on Medicaid is shifting towards expansion but timing is crucial. The legislative session ends on Feb. 22. A few of the 20 Republican senators, including the influential Senate Finance chair, joined 20 Democrats to craft a bi-partisan budget amendment that passed Medicaid expansion by voice vote. The state's lieutenant governor, a Republican, also supports the expansion.

The newly proposed Senate budget would require Virginia to put in an initial $1.1 billion into next year's budget but get reimbursed by the federal government under the Affordable Care Act. The state would still have to cover $137 million in administrative costs spread over the next 10 years. Marco Grimaldo, CEO and president of the Virginia Interfaith Center for Public Policy, says the benefits Medicaid expansion would bring to the state are compelling — including making health insurance available to the elderly, disabled and childless couples like the stroke victim.

"Virginia is stingy when it comes to helping low income people with Medicaid," says Grimaldo. Only six states have a more restrictive Medicaid formula according to data from the Kaiser Family Foundation.

Most of those who will benefit from Medicaid expansion in Virginia earn between 30 percent and 100 percent of the Federal Poverty Level (FPL). The FPL takes into account family size. For example, in Virginia, if the adults in a family of three collectively gross $5,800 a year, or just slightly more than 30 percent of FPL, the family is ineligible for Medicaid assistance. Up to a yearly gross income of $19,090, or 100 percent of FPL for a family of three, the state would still not provide Medicaid assistance.

If Virginia opts in for Medicaid expansion now, the federal government will pick up the full costs of covering those in the gap for three years, from 2014 through 2016. Thereafter, the state will never pay more than 10 percent of those costs, "a very good deal for Virginians," Grimaldo notes.

The governor had stripped the $1.1 billion out of his submitted budget, so Medicaid expansion advocates like Grimaldo, Khan and Jefferson are urging the entire legislature to restore those funds as the Senate has done. If it does, the governor could veto the budget, requiring another legislative vote to override.

Grimaldo is optimistic. "On really key votes on certain occasions," he says,"we have seen bipartisan agreement."


New America Media, Video, Article: Khalil Abdullah / Video: Min LeePosted: Feb 15, 2013

VCV’s Star Staff!

Kathy May and Erin Steigleder recently had the opportunity to talk about VCV's work on Delegate Ken Plum's cable news show, Virginia Report". We appreciate the invitation, Delegate Plum!