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Medicaid expansion: A win for all Virginians
Covering the poor while growing the economy

Date published: 1/30/2013

By Dr. Christopher Lillis and Jill Hanken

GIVEN a roomful of people, most people can’t tell by looking which ones don’t have health insurance. But the emergency-room doctor knows who they are. They’re the patients who show up when they’re too sick to ignore their medical problem any longer. When they leave with their prescriptions, they probably won’t fill them, because they can’t afford to.

The legal-aid attorney knows them, too. They are low-wage workers or people who lost their insurance when they lost their jobs. They broke a leg, or developed cancer, or went into heart failure that required hospitalization. Now, they’re seeking relief from constant calls trying to collect on impossibly high bills for the care that saved their lives.

More than 1 million Virginians are uninsured—one in eight citizens of the commonwealth. Virginia now has a chance to bring 400,000 of them into the Medicaid program. The federal government will foot the bill for those newly eligible, at 100 percent for the first three years and no less than 90 percent after that

Who would benefit? All of us.

People whose annual income is within 138 percent of the federal poverty line—about $15,400 per year for an individual and $32,000 for a family of four—would be covered. They would have access to care that most take for granted: yearly check-ups, prescriptions, cancer screenings, and medical intervention at an early, treatable stage.

Regular primary care with an emphasis on prevention and healthy lifestyles will help them be more productive employees and more effective parents, at a lower overall cost.

The rest of us would benefit, too. After all, we are already paying for the care of the uninsured. Our premiums are higher because we subsidize what the uninsured cannot pay. Our federal, state, and local taxes also support indigent care.

By extending Medicaid, we would ensure that Virginians’ federal tax dollars would come back to help Virginia’s low-income workers and families, instead of paying for expansions in other states.


Virginia’s economy will benefit, too. After comprehensive study, Virginia’s Medicaid agency concluded that over a 10-year period, the commonwealth would receive more than $20 billion in federal funding, while spending less than $150 million for the state’s portion of the expansion.

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