By Sen. Barbara Favola
Affordable healthcare is essential to the vibrancy of Arlington. It’s essential to giving everyone a fair shot at a decent living, along with other key elements such as education, jobs and housing.
Yet not all Arlingtonians have access to high quality, affordable health care. Today, 6.7% of Arlingtonians under 65 do not have health insurance, generally because they cannot afford it. By making healthcare more affordable and more focused on wellness, families would have more income to pay for housing and other necessities.
That is why in the General Assembly, I have been working toward a public option insurance plan. Under a public option plan, state lawmakers could require that essential health benefits such as primary and preventive care and mental health services be covered. Hospitalization and rehabilitation benefits would also be included. In short, we could create a required benefits package that promotes health.
A public option health insurance plan would expand insurance opportunities using private-sector insurance partners rather than replacing existing sources of coverage (e.g., employer-sponsored plans, the marketplaces, Medicare and Medicaid). There are also cost savings opportunities with public option plans. For example, a public option insurance plan could negotiate reasonable (not excessive) provider payment rates because providers would want to avail themselves of such a large share of the patient market.
It would also be possible to tie reimbursement rates to health outcomes, providing an incentive to keep individuals healthy rather than rewarding multiple visits to a provider. Such leverage would help lower premiums in the private market and encourage healthy behaviors.
If Virginia implemented a public option insurance plan and used federal and state funds to subsidize the premiums for those between 138% and 500% of poverty, I believe that the 6.7% of Arlingtonians who do not have health insurance could afford coverage.
Why Do Some Families Have Trouble Paying for Health Care Insurance Now?
Families with incomes below 138% of the federal poverty level ($36,156 for family of 4) qualify for Medicaid or Medicaid expansion, so they are covered now. However it is households with incomes between 138% and 500% of the federal poverty level ($131,000 for a family of 4) that face difficulty purchasing health insurance. In Arlington, approximately 40% of households are earning between $35,000 and $125,000 annually.
With the removal of an enforceable mandate under the Patient Protection and Affordable Care Act (ACA), younger and healthier individuals are not buying insurance. This has created an environment where the cost of care is being distributed among a smaller and sicker pool of insured individuals. The result is a continual increase in health insurance premiums. For many who want to put in place a plan to pay for their health care, the expense of paying increasingly high health insurance from their disposable income is too burdensome.
Other Tools to Rein in Health Care Costs
Last year, my bill to end what’s known as “surprise medical billing” in Virginia passed. No longer will patients who receive out-of-network care in an emergency room or from a specialist during a planned procedure, be responsible for more than their usual co-pay or deductible. This new law sets up a process for insurance companies and providers to negotiate a fair reimbursement without the involvement of the patient.
For the 2021 session, I am submitting a bill to require the state to cover the costs of certain excessive insurance claims in an effort to slow the rate of increases in insurance premiums. This is called a reinsurance program. Several states have implemented such a program and have seen success in stabilizing the insurance market and premium costs. Gov. Ralph Northam’s team is evaluating this proposal and various ways of paying for the reinsurance fund.
Virginians Want and Need Affordable Healthcare
While much of the opportunity to make healthcare affordable requires federal policy reform, I
am working diligently to ensure that the laws of the Commonwealth are helping as much as possible to provide every Virginian with access to quality, affordable healthcare. I think we can all agree that access to healthcare is one of the building blocks for achieving a fair shot at a decent life. Together, we can make this a reality.
Sen. Barbara A. Favola represents Virginia’s 31st Senate district, which includes parts of Arlington and Fairfax counties, and a portion of Loudoun County. She is the Chair of the Senate Rehabilitation and Social Services Committee. Favola has championed many health, education and childcare improvements, such as the expansion of subsidies to improve access to quality early childhood education.
The following letter to the editor was submitted by state Sen. Barbara Favola (D-31) and Del. Kaye Kory (D-38), the chairs of the Reproductive Health Caucuses in the Senate and House of Delegates, respectively.
Our health care system is neither healthy nor accessible for many women, but Richmond lawmakers have an opportunity to make improvements. They need to stop playing politics with people’s lives and begin to start governing.
In large swaths of Virginia, particularly in low-income neighborhoods, women are suffering. This suffering affects the well being of all of us, not just the children and communities that are directly affected.
You probably didn’t know that childless, uninsured women are not eligible for Medicaid in Virginia even if they are planning to have children. Moreover, for many mothers who are eligible, they lose their Medicaid coverage 60 days after giving birth because they exceed the very low income requirements to qualify for Virginia’s sparse Medicaid program. This exacerbates an already stressful period in a mother’s life.
In fact, mothers in most parts of Virginia qualify for Medicaid only if they earn less than 40 percent of the federal poverty line. This means that a single mother in Richmond cannot receive Medicaid if she makes $6,100 a year or more. But if Virginia participated in Medicaid Expansion, a program for which we are already sending tax dollars ($5 million per day) to Washington, hard working individuals, including women, earning up to 138 percent of the federal poverty line would gain insurance coverage. Virginia’s tax dollars are supporting Medicaid Expansion in 29 other States but not here at home!
Medicaid expansion may not be perfect, but the cost of not going forward is astronomical. We all know that maternal health is critically important for the healthy development of a child. This means that prospective moms can only achieve a healthy state if they have access to care before pregnancy as well as access to pre- and post-natal care. Preventing low-birth weight babies and developmentally delayed babies is something we must embrace. Virginia cannot afford to wait; we must pass Medicaid Expansion now.
Progressive Voice is a weekly opinion column. The views and opinions expressed in this column are those of the author and do not necessarily reflect the views of ARLnow.com.
On key issues like school desegregation, rights of Virginians with disabilities, providing workplace benefits and protections for LGBT Virginians, mental health treatment, women’s equality, protecting reproductive rights, and advocating for environmental protections, Arlington’s General Assembly members have fought tirelessly and effectively to overcome conservative forces that have held Virginia back from achieving its potential.
Outstanding elected officials like Mary Marshall, Mary Margaret Whipple, Ed Holland, Judy Connally, and Bob Brink are among those who have achieved progressive victories in Richmond. They have also fought harmful legislation that conservative legislators — most recently in the Republican caucus — pushed forward in response to calls for party loyalty regardless of the interests of constituents at home.
As we approach the House of Delegates 48th District Special Election on Aug. 19, I hope we will follow the example set by legislators like Bob Brink and ensure that Arlington’s interests are not sacrificed to partisan conservative interests in Richmond.
We have two candidates for the 48th District who have been longtime residents of Northern Virginia and are known as being personable, professional, civically engaged, and respectful of others.
However, I hope voters recognize that these candidates have some major policy differences on issues that will come up on a regular basis in the General Assembly.
Given that the candidates will have only weeks to communicate their legislative platforms, ideas, and perspectives with voters in the 48th District, I thought it important to highlight a few of their policy differences.
Rip Sullivan believes we can and must fix the gun show loophole, which allows certain sellers to avoid running background checks on buyers. This is how some people who shouldn’t own guns acquire them. He will fight to close the gun show loophole. His opponent, Dave Foster, said in his 2009 attorney general’s race for the Republican nomination that the gun show loophole is not a loophole.
Rip believes our national parks, like Great Falls, are sacred grounds where we should be able to run, hike, swim, and picnic without the fear of a gun discharging. Dave has said he wants to eliminate the ban on carrying firearms in national parks.
Women’s Reproductive Rights
Rip believes that reproductive health decisions should be left to a woman and her doctor, and that the government has no business interfering. Dave has said he opposes abortion and that Roe v. Wade was a case of “judges imposing their will.”
Defending the Status Quo on Testing Requirements
While serving on the Virginia State Board of Education, Dave Foster resisted SOL reform that would have made common sense adjustments to state testing requirements. Rip Sullivan supported the 2014 law reducing the number of standardized tests and providing more flexibility to localities and teachers to determine how best to ensure that students are learning the necessary curriculum.
Supporting Conservative Politicians
Dave has called Ken Cuccinelli a “great legislator,” and supported Cuccinelli for attorney general in 2009 and governor in 2013. He has endorsed and financially supported Virginia Tea Party leaders and is former chair of GOPAC-Virginia, a fundraising arm of the Republican National Committee. Read More