Statewide Medicaid Expansion in 2018 Backed Amid New Research

SITTING SIDE BY SIDE during last Friday’s forum to expand Medicaid are Rev. Dr. Clarence Brown Jr. (left) and Sen, George Barker. Both felt expansion was morally necessary as well as financially savvy. (Photo: Maureen Murphy)

A push to expand Medicaid coverage throughout Virginia was the focus of a public forum hosted by the Virginia Interfaith Center for Public Policy’s Northern Virginia Chapter and Culmore Clinic at the Columbia Baptist Church by Bailey’s Crossroads on Dec. 1.

Senator George Barker from Virginia’s 39th District was one of the speakers at the event and estimated that Medicaid expansion may not be feasible in the upcoming 2018 legislative session, but by 2019 it should be well within the General Assembly’s reach. However, other members of the legislature are hopeful that expanding Medicaid can be agreed upon once the governing body convenes in early January due to November’s election results.

“As a faith leader [and] generally across the theological standpoint, the ethical component of all of our faith’s stances is a concern for the least, the last, the lost, the left out and the left behind,” Reverend Dr. Clarence Brown Jr., senior pastor for Annandale United Methodist Church, said. “We have a moral imperative to seek after their wellbeing.”

Friday’s discussion was one of 11 similar events that took place throughout the state. Each location shared a group of prominent figures from religious, medical and political backgrounds. Speaking alongside Barker and Brown was executive director of Neighborhood Health, Dr. Basim Khan, who lamented how most care low-income populations receive is at the hospital, not a primary care physician or a specialist. Their collective presence and comments carried a sense of urgency to grow the government healthcare program that helps people who fall significantly below the federal poverty level.

The inertia for expansion comes on the heels of a new joint report by the Virginia Poverty Law Center (VPLC) and The Commonwealth Institute (TCI) titled, “How Medicaid Works: A Chartbook for Understanding Virginia’s Medicaid Insurance and the Opportunity to Improve It.”

According to the report, Virginia’s stringent Medicaid eligibility requirements exclude many low-income families who earn too much to qualify for the program but also earn too little to qualify for subsidies in the marketplace. For example, for a family of three living in the City of Falls Church or Fairfax or Arlington County to qualify for Medicaid, the household’s annual countable income can’t exceed $10,524. As the report states, it gives positive news such as a job promotion a negative tone since the increase in wealth could disqualify a family from their healthcare program.

That may explain why even though 21 percent of the Bailey’s Crossroads community lives in poverty, 57 percent of those residents remain uninsured. An accompanying press release from the Virginia Interfaith Center reveals that 5,900 Alexandria residents, 7,700 Arlington County residents and 30,000 in Fairfax County fall into the coverage gap due to current Medicaid requirements. And while Health and Human Resources receives the second-most dedicated funding in Virginia’s state budget – with a $500 million bump from FY 2017 to FY 2018 – Barker argues that more investment to expand Medicaid now is sound financial strategy in the long-run.

DISCUSSING some of the challenges that low-income patients experience is Dr. Basim Khan. One area Khan noted is that due to the high cost of visiting specialists, many underprivileged patients are locked in a cycle where their only steady treatment comes in emergency rooms. (Photo: Maureen Murphy)

“We will actually save money – even if we have to put in a little bit of state money – we will save more on what we’re spending now on other programs for these very same people in many ways,” Barker said. “It not only helps the people receive quality care, but it helps the bottom line of Virginia at the state level and presents the opportunity to address other services.”

As it stands now, Medicaid coverage targets certain populations among low-income residents. Per the report, children (59 percent), disabled adults and children (19 percent), low-income parents (15 percent) and seniors (seven percent) total those who receive care from the program. In broader terms, Medicaid covers three out of 10 poor adults, two out of three poor children and one out of every ten Virginians. Nearly one million people are covered by Medicaid at any given time in Virginia.

Excluded from Medicaid coverage are 240,000 Virginians, who are mainly childless adults, veterans and people of color. That’s why the VPLC and TCI believe Virginia lawmakers should take the option to expand Medicaid coverage for most adults to 138 percent of the federal poverty level that’s been offered to states. The increased threshold would allow individuals with an annual income of $16,643 and families of three with an income of $28,180 to be eligible for Medicaid.

The addition of a new demographic group in childless adults as well as a roughly 270 percent increase in the threshold for the three person families does open the door for an influx of Medicaid patients and, subsequently, necessary funding. However, the report states that Virginia’s share of the expansion cost is limited to 10 percent, with an overwhelming chunk of it coming from the federal government.

There’s also the oft-repeated concern that having health coverage does not equal quality care. Many doctors are reluctant to accept new Medicaid patients due to challenges in receiving government reimbursement. When doctors do accept new Medicaid patients, it’s typically newer, less-experienced doctors attempting to build their clientele. These practitioners usually struggle to provide adequate care to patients who frequently have multiple health problems as a result of no prior coverage before applying for Medicaid.

But seven out of 10 doctors are currently accepting new Medicaid patients, according to the report. And Barker assured that even with Virginia’s low investment per resident in Medicaid (which ranks 46th out of 50 states), the quality of care for Medicaid patients is still some of the highest in the U.S.