Should Virginia expand Medicaid eligibility under the Affordable Care Act?
Virginia can control its destiny with Medicaid expansion
There are a number of reasons opponents of Medicaid expansion cite for not wanting to move forward with expansion and accept federal money (up to $2 billion per year) that is Virginia’s potential share. The funds are intended to provide health care access to as many as 400,000 low-income, uninsured Virginians.
While we should all agree that our federal government needs to balance the budget and cannot afford to simply borrow money to pay for current operations, Medicaid expansion has a series of funding streams that we will be paying for, one way or another.
Under the Affordable Care Act, a number of measures were adopted in order to pay for the program. Through a combination of taxes, cost savings and a re-direction of existing funds, the money that would come to Virginia is already being paid for by Virginians.
We can control our destiny with Medicaid. We can accept expansion with the understanding that we have the option to reverse course if the federal government does not honor its commitment.
Yes, Medicaid needs reform, and the impetus for reform is one of the main reasons that I am a proponent for strategic expansion.
We have delineated an aggressive agenda for reform, and the administration is already making a lot of progress to achieve our goals. We have already agreed to expand Medicaid if these goals are met and to suspend our program if the federal government does not honor its commitment. Savings attributed to the revised program would be placed in a special fund in case there are shortfalls in future years.
I am pro-life and support government protections for the unborn. Being pro-life must extend well beyond birth and childhood. I feel it is an appropriate role of government (in our role as protectors of life, liberty and the pursuit of happiness) that we focus on quality of life for all our citizens by ensuring that adequate health care is both available and affordable for all our citizens.
Hanger, R-Augusta County, represents the 24th District in the Virginia Senate and is chairman of the General Assembly’s Medicaid Innovation and Reform Commission.
Virginia could get stuck with a large bill
Sen. Emmett Hanger and I agree that Medicaid reform is the first step. But we disagree on the second step. Enacting serious reforms to Medicaid would make expansion slightly more palatable, but not necessarily easier to swallow.
The second and most critical step before Virginia considers expansion is guaranteeing that taxpayers will not get stuck with the bill.
Proponents of expansion have argued that “it would be foolish” for Virginia to turn down “free” federal money appropriated for expansion. But as the saying goes, there is no such thing as a free lunch.
Medicaid is considered mandatory spending by the federal government. That means no matter what it costs, the federal government pays for it — or rather, borrows money to pay for it. Expansion will be paid for the same way. The federal government has laid a blank check on the table and will just borrow whatever it needs to pay for it.
When a state chooses not to expand Medicaid, that money does not get spent somewhere else. It simply does not get borrowed and spent at all. A study recently quoted in the Wall Street Journal estimated if only half the states reject expansion, the federal deficit could be reduced by more than $500 billion.
If and when the federal government is forced to deal with its spending issues, and decides it cannot continue to cover the full costs of Virginia’s 400,000 new Medicaid participants, Virginia taxpayers will be stuck holding the bag.
Knowing that any money spent by the federal government is really just borrowed money, and knowing that the federal government has $16 trillion in credit card bills, makes it easier to understand why Virginia cannot rush into expansion.
Taking an IOU from Washington is almost never the responsible thing to do. Medicaid expansion is no different.
Landes, R-Augusta County, represents the 25th District in the Virginia House of Delegates and is vice chairman of the General Assembly’s Medicaid Innovation and Reform Commission.