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February 20, 2015

There’s More Where That Came From

Even though Virginia has embraced only part of national health care reform, we are seeing strong results. Imagine what could happen if state lawmakers were to fully implement all the reforms by closing the gap that continues to deny coverage to 195,000 Virginians.

Nearly 385,000 Virginians signed up for private health insurance this year through the marketplace, according to a report from the U.S. Department of Health & Human Services. That’s 168,000 more than last year, exceeding the goal set by Governor McAuliffe before enrollment opened up last fall.

Why the jump? When Virginia lawmakers declined to establish a state-run insurance marketplace, they relied instead on the federal government. As a result of this choice, the state was unable to get federal funding to pay for consumer assistance, leaving many Virginians unaware of their coverage options and with very few ways to get in-person help.

This changed in September 2014, when Governor McAuliffe released his Healthy Virginia plan. It allowed Virginia to tap $13.6 million in federal grants to hire 21 outreach specialists to promote the marketplace and 118 in-person assisters to help consumers enroll.

Clearly that investment has paid off.

There is another part of national health reform that would have huge benefits for Virginia if lawmakers would agree to close the coverage gap, like 28 other states and Washington, D.C., have.

The 195,000 Virginians who fall into the gap make too little to get tax credits that would help them afford coverage in the marketplace and too much to qualify for the state’s meager Medicaid coverage. A single adult who makes up to $46,680 a year can get tax credits to buy insurance, while those who make less than $11,670 are neither eligible for tax credits nor the state’s Medicaid program unless they are blind, disabled, or pregnant.  

So far, Virginia has turned down $1.82 billion in federal funding to provide coverage to these individuals. That’s because for all of 2014 and into 2015, the federal government would have paid 100 percent of the costs to cover the Virginians in the gap. That offer stands through 2016, and after that the federal government will pay no less than 90 percent of the cost.

Instead of crafting a solution that would tap these funds, state lawmakers have resorted to a piecemeal approach that is costing tens of millions of dollars and only helping a fraction of the people who fall in the gap.

The benefits of national health reform are playing out in Virginia with enrollment in the marketplace and in other states that have closed their coverage gaps. Virginia lawmakers’ continued refusal to chart a real path forward comes at our expense.

–Massey Whorley, Senior Policy Analyst

The Commonwealth Institute

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