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The Right Note: Medicaid Expansion in Virginia?

Mark KellyThe Right Note is a weekly opinion column. The views and opinions expressed in the column are those of the author and do not necessarily reflect the views of ARLnow.com.

Republicans in the General Assembly have rejected Gov. Terry McAuliffe’s (D) call to expand Medicaid once again. The governor made the last minute push after Congress failed to pass a new plan in March. Here are four reasons to question the wisdom of passing expansion.

Congress could still partially repeal the law this year. Reports from Washington are that the American Health Care Act could be amended in such a way that it will have the votes to pass. If so, Virginia’s expansion would not be able to go forward even if it passed the General Assembly.

Virginia is not losing out on a pot of federal money sitting out there just waiting to be spent. The federal government is running an estimated $559 billion deficit his year. We would simply be borrowing more money to pay for Medicaid expansion.

Virginians will be responsible for at least 10% of the expansion costs. Assuming McAuliffe’s assertion that Virginia could collect $6.6 million per day under Medicaid expansion, Virginians would have to pay around $700,000 per day to receive it. Even if the law remains in place, this share is likely to go up over time as the federal budget deficit moves toward $1 trillion a year.

My friend over at Peter’s Take noted that Virginia Hospitals have offered to cover Virginia’s share. It should make Virginians wonder exactly how much money hospitals stand to make under the arrangement? In many states that implemented expansion, costs to the state were higher than originally projected, so we could also ask just how much the hospitals are willing to pay and for how long?

Medicaid is still substandard healthcare. Many studies have found Medicaid produces worse health outcomes, in large part due to lack of access to primary care physicians. A better focus for McAuliffe and the Republican-controlled General Assembly should have been working together to pass tax and regulatory policy changes that result in economic growth and create jobs with health insurance benefits to move individuals into the private market.

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