Progressive Voice: On the Cusp of Medicaid Expansion in Virginia

Progressive Voice is a weekly opinion column. The views and opinions expressed in the column are those of the individual authors and do not necessarily reflect the views of their organizations or

By Rip Sullivan

Imagine this: a family of three living in Arlington County. The father and mother work hard at hourly wage jobs, cleaning hotel rooms and working at a fast food restaurant to try to make ends meet.

Together they make $18,000 a year — someone needs to be home at all times to watch over their very young daughter. Neither parent receives health insurance from their employer, and unfortunately they make “too much” to qualify for Virginia’s Medicaid program. These parents are stuck in what is known as the “coverage gap.”

Here in Arlington, approximately 7,000 of our citizens — our neighbors — are stuck in the coverage gap, according to the Commonwealth Institute. Virginia is ranked 13th worst in the country on percentage of population that is uninsured, and 8th worst in the number of people uninsured.

Having some of the country’s most restrictive Medicaid requirements doesn’t help. For instance, childless adults are not eligible. Neither are elderly or disabled people with incomes above 80 percent of the federal poverty level, or $15,273 for a family of three.

Being insured provides critical benefits not only to the individual with health care coverage, but to society at large. Cash-strapped hospitals save money by reducing the amount of uncompensated care, and individuals get preventive care before requiring expensive trips to the ER.

How can we shrink the number of uninsured in Virginia and help those in the coverage gap? Expand Medicaid now.

Democratic candidates for the House of Delegates in 2017 made Medicaid expansion a major part of our platform in districts across the Commonwealth. In November’s wave election — in which Democrats flipped 15 seats in the House and retained the Governor’s seat — voters made it clear that health care accessibility was a priority.

In a CNBC exit poll, nearly 70 percent of Virginia voters said that health care “was the most important or a very important issue in deciding whom to vote for as governor,” and a Washington Post poll found that health care was the number one priority for 39 percent of voters, the highest of all categories considered. A December 2017 NPR poll found that 70 percent of Virginians support Medicaid expansion.

Virginians are ready for more of their neighbors to get Medicaid coverage. So what’s the hold up?

Last week, the House of Delegates passed — for the second time — a budget that included Medicaid expansion. The breakthrough came from a compromise between House Republicans and Democrats and the governor.

This agreement would include work requirements (with several exceptions that would exempt a large percentage of the affected population), small contributions from enrollees, and permission for the Northam administration to seek a federal waiver to find ways to stabilize and make health insurance exchanges more affordable.

Now, all eyes are on the state Senate, which is controlled 21 to 19 by Republicans. Fortunately, two Republican senators have suggested that under certain conditions they would support Medicaid expansion. As Republican Senator Emmett Hanger noted, funding for Medicaid in other states is supported by “dollars [that] came out of the pockets of Virginia taxpayers and we need to put them to use.”

He is right — Virginians have already paid billions of dollars in taxes to the federal government that are currently being used to fund Medicaid expansion in other states. Virginia’s expansion is long overdue — over three-fifths of states have already chosen to expand Medicaid.

Medicaid expansion now hinges on the Senate Republicans, starting with the Senate Finance Committee, which includes the two Republicans in support of limited expansion.

There is no formal date yet announced for the committee’s next meeting, but the General Assembly must pass a budget by midnight on June 30 or the state government will shut down.

We can do better than to leave Virginia families struggling in the coverage gap, fearful that one illness could plunge them into abject poverty. I am hopeful that Senate Republicans will come to the same conclusion as House Republicans did — Medicaid expansion is what voters want and what Virginians deserve.

Richard C. “Rip” Sullivan, Jr. is a member of the Virginia House of Delegates from Virginia’s 48th District, which encompasses parts of Arlington and McLean. He practices law in Arlington with Bean, Kinney & Korman.

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