Reading Between the Lines

Virginia’s current Medicaid rules create a patchwork of coverage for women, threatening their health and the health of their children. But expanding the program could fix that.

The Virginia Council on Women, appointed by Governor McDonnell, seems to recognize that, too. In its report to the governor made public Monday, the Council recommended that the state’s “Medicaid Innovation and Reform Commission should consider the unique needs of women and those with disabilities” as it decides when to accept the federal dollars to expand Medicaid coverage under the federal Affordable Care Act.

Indeed, it should.

When women have health coverage before becoming pregnant, they are healthier during their pregnancy and their babies are more likely to be healthy at birth. That saves on health care costs in the long run. Yet today, thousands of low-income, working women in Virginia do not have access to continuous health coverage.  

Under current Medicaid rules, many low-income women become eligible for coverage only when they are pregnant. But soon after giving birth, they may lose that coverage because eligibility is much tighter for women who are not pregnant. And, of course, women who don’t have children are not eligible for Medicaid no matter how little they make.

To see how this plays out, consider a married woman who is expecting her second child. She is eligible for Medicaid if she and her husband earn about $29,000 a year or less. But shortly after giving birth, she would only continue to receive Medicaid coverage if they earn about $7,000 a year or less.

Expanding Medicaid would provide continuous health coverage to low-income women whether or not they are pregnant, resulting in better health not only for the women who gain coverage but also for the children they have in the future. And because Medicaid already covers the costs of delivery for many low-income women – and for the care of children – better care for women before pregnancies can lower overall Medicaid costs.

The governor’s Council on Women recognized a unique opportunity to improve the health of women and their babies. Expanding Medicaid would do exactly that.

–Massey Whorley, Senior Policy Analyst