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August 27, 2013

Like a Rocking Chair

Medicaid expansion is a great deal for Virginia. The federal government will pay 100 percent of the cost through 2016 and then no less than 90 percent after that. Yet some members of the Medicaid Innovation and Reform Commission (MIRC) are worried about what would happen if the federal government reduced its commitment to pay for Medicaid expansion at some point in the future. This concern overlooks reality and the safeguards they themselves put in place to deal with this extremely unlikely possibility.

First, and most importantly, there is no precedent for Congress voting to decrease the matching rates for programs like Medicaid. This point was made clear by Dr. Vernon Smith, a Medicaid expert who testified at the August MIRC meeting. “Something like that has never happened,” he told the MIRC. “It, in my judgment, would be extremely unlikely.”

Second, even if it did, the Virginia legislature already protected itself. That’s because the Virginia budget that authorized expansion allows the state to automatically end it if the federal commitment is reduced at any point in the future.

MIRC members are right to take a thoughtful approach to their work. But worrying about the future actions of Congress doesn’t get Virginia any closer to helping the nearly 400,000 uninsured Virginians who could get coverage through Medicaid expansion. With safeguards in place, the MIRC needs to focus on how Virginia can move forward.

–Massey Whorley, Senior Policy Analyst

The Commonwealth Institute

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