Skip to Content
June 14, 2018

Celebrating Important Progress for Virginia Workers and Families

When Governor Northam signed a budget that included Medicaid expansion on June 7, it was the culmination of years of work by hundreds or even thousands of Virginians, and will mean real improvements in the lives of hundreds of thousands of Virginia workers and families. Medicaid expansion has been at the center of Virginia policy debate for six years, and The Commonwealth Institute has been highlighting the benefits of this policy all along.

When Medicaid expansion is implemented, no later than January 1, 2019, nearly 400,000 people in Virginia will be eligible for health insurance through the program. This increase in insurance coverage is because Virginia’s strict Medicaid eligibility with regard to income will be a thing of the past.


For decades, many people in Virginia were not eligible for health insurance through Medicaid even if they were below the federal poverty level. This included many disabled adults and working parents. Childless adults were not eligible no matter how little money they made.

Maintaining eligibility was especially a highwire act for working parents as Medicaid eligibility varied by locality. If a working mother lived in Charlottesville and earned $10,500 a year, she would be eligible for Medicaid. But if she moved to the surrounding county of Albemarle where the maximum allowable income was $7,956 a year, she would suddenly be without health insurance. And parents in the majority of localities in Virginia could only make up to $6,720 before losing their health coverage.

Expanding Medicaid gets rid of this complicated system for working parents in Virginia.  Now, Virginia will have one statewide eligibility level. Working parents in a family of three will be able to earn up to $28,676 a year (in 2018) without fear of losing eligibility no matter where they live.


As TCI and the Virginia Poverty Law Center highlighted in How Medicaid Works: A Chartbook for Understanding Virginia’s Medicaid Insurance and the Opportunity to Improve It, many groups will be helped by Medicaid expansion. This includes more than 12,000 veterans who will gain access to primary or supplemental health insurance through Medicaid, workers within key sectors of the state’s economy, and communities of color.

With increased eligibility for health insurance, Virginia is likely to regain its status of having below-average uninsured rates. In 2013, Virginia’s uninsured rate was below that of the United States as a whole – 12.3 percent compared to 14.5 percent. While Virginia’s uninsured rate decreased between 2013 and 2016, due to lack of Medicaid expansion Virginia had a slightly higher rate of residents without health insurance in 2016 compared to the U.S. Surrounding states that had expanded Medicaid had much larger decreases in their uninsured rates. When the 2019 health insurance data is available in 2020, we should see a large drop in the number and share of Virginians who are uninsured.

Beyond the uninsured rate, Medicaid expansion will have other positive impacts on the commonwealth. Not only will expansion support approximately 18,000 jobs, but those who gain health insurance through Medicaid will likely find it easier to look for and secure employment, and do better in their jobs.

In accepting federal dollars and adopting a provider assessment to pay for expansion, the state will save around $370 million dollars over the next two years – savings that are being used for increased investments in mental health services, and pay raises for teachers, some law enforcement, and behavioral health staff.

Medicaid expansion is a great example of how policy has direct impacts on people. It may also be the most significant step towards economic opportunity that Virginia has taken in years – just one reason that lawmakers who were once opposed to expansion had a change of heart. The long-term advocacy by constituents and lawmakers, and the recent change of heart by some, will change the lives of people in every legislative district and every locality across the commonwealth.

The budget and its inclusion of Medicaid expansion is a victory to be celebrated. But the work continues, and there will be more victories to celebrate as people enroll and access quality health care, and Virginia becomes a healthier, more prosperous state for all.

Economic Opportunity

Sherri Egerton

Back to top