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March 17, 2016

Virginia Health Care Expansion for Some Highlights the Void for Others

The fact that the state House and Senate were willing to expand health care for some people in the budget they agreed upon highlights how damaging their refusal to close the coverage gap is for others.

Let’s take a look at two examples.

Both chambers deserve credit for coming together on a budget that increases funding for some critical health care needs.The approved budget, for example, makes limited medical care available for an estimated 3,600 more people suffering from serious mental illness. By devoting an additional $5.4 million in state funds along with an equal federal match, lawmakers increased the eligibility level in this program for a single person to approximately $10,000, up from roughly $7,700.

Though that is an important step, it is reflective of the legislature’s overall approach to health care. Lawmakers doubled down on the flawed belief that it is better to partially expand health coverage for some people in a way that costs the state money, than to fully expand coverage for more people in a way that saves the state money.

Closing the coverage gap would provide people whose income is below $16,200 for a single person – including those with serious mental illness – access to the full array of health care services and it would save the state money. In fact, closing the coverage gap would save the state an estimated $106 million over the next six years just from the current program for people with serious mental illness.

Lawmakers did a similar thing when they expanded existing Medicaid coverage to include substance use disorder treatments. With a price tag of $11 million in state funds and an equal amount of federal funds over the next two years, this new benefit will mean increased access to lifesaving services for people currently eligible for Medicaid.

But the new treatment services don’t extend to people who are currently ineligible for Medicaid, leaving out 400,000 people – including nearly a third of whom are parents. So while some low-income parents will be able to get the treatment they need to get better and help their families, other parents who only make slightly more money are left without any help.

In his post-legislative session letter to lawmakers, the governor expressed his disappointment that the legislature did not close the coverage gap noting, “Their failure to act is costing us $6.6 million a day in federal dollars that could be providing much-needed medical services to our families.”

For people who will get the newly expanded coverage, there will be welcome relief. But for people who still can’t get insurance, there’s no relief in sight.

–Massey Whorley, Senior Policy Analyst

The Commonwealth Institute

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