Expand Medicaid in Virginia

Our economy is slowly improving, but we're still in a perilous place. Too many Virginians don't have jobs, and many of those who do have jobs are still struggling to support themselves and their families - especially when it comes to providing health insurance.

We have a long way to travel before we return to pre-recession levels of employment and prosperity. With this situation in mind, Virginia should take the opportunity to help more people acquire health insurance by expanding Medicaid.

About a million people in Virginia lack health insurance. Many of these people are working hard, but they simply can't afford the expense at the end of each month. They are forced to go without health care; their only option is to wait until they're truly sick and then show up in an emergency room.

Unfortunately, emergency room care is extremely expensive for the rest of us. It's also no substitute for the kind of care that actually keeps people healthy: regular, preventative care from a doctor who knows their medical history. If we reform Medicaid, between 300,000 and 400,000 Virginians will suddenly have access to this type of care. That change will help countless families.

Increasing coverage is also good for jobs and the economy.

The federal government will pay 100 percent of the costs to expand coverage in 2014, 2015 and 2016. After that, it will pay at least 90 percent.

Over the next decade, Medicaid expansion will put $29 billion into Virginia's economy. With this money, we can insure hundreds of thousands of hard-working Virginians at minimal cost to the state.

Moreover, that $29 billion will spur growth and create jobs in the health care sector as new beneficiaries begin to use regular health care services. Medicaid expansion is a chance for us to create lots of jobs at very little cost.

The people most likely to benefit from expanded coverage are the same people who work two or three jobs in order to support their families. These are people you know - people you see every day. They work at coffee shops and department stores. They fix your car. They build houses. They may even be caring for your elderly parents or grandparents.

But unless we do something, they simply can't afford health coverage.

Expanding Medicaid saves the state money. For instance, it allows us to significantly reduce indigent care subsidies that would otherwise cost more than $100 million every year. We could also save $12 million annually on mental health care services. And private insurance premiums - including what state government pays for employee health insurance - should rise more slowly as the cost of uncompensated care is reduced. That alone could save us between $17 million and $42 million every year.

Opponents of Medicaid expansion - like Gov. Bob McDonnell - criticize the cost of making Medicaid available to so many more Virginians. But while the governor complains about expense, even his own estimate shows that the cost of expansion is just about balanced by the millions of dollars the state will save.

Moreover, the proposed expansion would be paid for with our federal tax dollars. If we don't expand Medicaid, our money will go to help other states provide health care for their citizens. In effect, we've already paid for Medicaid expansion; now, we need and deserve our fair share.

If Virginia doesn't expand Medicaid eligibility, all of us will continue to subsidize inefficient emergency room care for those who can't afford health insurance. The cost of private insurance will continue to rise as costs are shifted to those who can pay.

Worst of all, hard-working citizens, their families and their children will continue to go without essential health care services. A major opportunity to achieve important goals - reforming the system, growing jobs, getting our fair share of federal resources and saving money - will have been lost.

The Supreme Court made expanding Medicaid eligibility optional for the states. For Virginia, the choice is clear: Expand coverage. Grow jobs. Save money. Help our fellow citizens who are struggling to support their families. The future health and well-being of our commonwealth depend on it.

Donald McEachin is leader of the Democratic caucus in the Virginia Senate. He lives in Henrico.

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