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Speak Out: Should Virginia Opt Out of Medicaid Expansion?

As Virginia lawmakers disagree over Affordable Care Act provision, tell us: Would participating in the expansion help or hurt the state?

As Gov. Bob McDonnell considers opting out of the , Virginia lawmakers are divided on whether the program would help or hurt the state.

In a letter to McDonnell on Thursday, Lt. Gov. Bill Bolling, a Republican who has announced a 2013 gubernatorial bid, encouraged the governor to reject the program, saying Medicaid expansion — which he says accounts for nearly 20 percent of Virginia's total general fund spending — would place "tremendous fiscal pressure on the Commonwealth and divert funds from other state programs, such as public education, higher education, public safety, natural resource protection and even other critically important health care programs."

McDonnell sent a letter to Virginia lawmakers Tuesday expressing his concerns with the program, saying opting into a Medicaid expansion — which would require the state to create exchanges through which residents could buy health insurance — without more policy information was irresponsible, according to the Washington Post.

The Republican governor said the program, and costs associated with it, could ultimately be unnecessary if a new Congress and president elected in November are able to repeal the act in 2013, the Post reported.

In his own letter to the governor and other leaders, U.S. Rep. Gerry Connolly, (D-11th District) said opting out of the program was a "costly mistake," one that would cause Virginia to lose out on the $9.2 billion in federal funds he says the state would receive in first five years of the program.

Connolly said federal funds would cover the first three years of the program, which would help about a quarter million uninsured Virginia residents.

"The choice we face as Virginia’s leaders is momentous. Will we move forward together to implement these historic reforms, reversing our unsustainable trajectory of spiraling costs? Or will we allow this once-in-a-lifetime opportunity to leverage billions of dollars of federal funds to help Virginia’s families, businesses, and bottom line?" Connolly wrote. "I urge you to seize this opportunity to make life better for all Virginians."

For every dollar Virginia spends on the program, it would receive $17 in federal money, the Post reported.

Bolling said increasing Medicaid enrollment, which he predicted would double by 2022, would cost $2.1 billion from the state general fund and another $31.3 billion in taxpayer money in that time.

Connolly cited figures from Virginia Health Reform Initiative Advisory Council, a committee McDonnell formed to help plan the implementation of the Affordable Care Act, that showed "ACA reforms, including the Medicaid expansion, would reduce uncompensated care costs borne by Virginia’s government, families, businesses, and hospitals by $860 million."

For the full Washington Post story, click here.

Tell us: Would participating in the expansion help or hurt the state? Leave your thoughts in the comments.

To see Connolly speaking on the Supreme Court's June health care decision, and McDonnell speaking on his recent letter, watch the videos in the media player above.

Kim Moore July 13, 2012 at 11:23 PM
VA should engage in the expanded Medicaid program. The exchanges will not only be for Medicaid beneficiaries but for small employers who otherwise would not provide insurance, and individuals who otherwise would not have an affordable coverage option. Expanding Medicaid to include exchanges will give more people access to coverage. Expanding the pool of covered-lives will help to bring down the costs. Premiums (no matter how small) will aid in spreading costs. Un-funded ER visits will decline, and those who are sick and currently "uncoverable" will have access to more affordable care. For years, states have been reducing Medicaid benefits, and doctors have been refusing to treat Medicaid patients. I hope that this plan will change that momentum and that Virginia will not opt-out.
Rudy Gonzales July 14, 2012 at 12:50 AM
One can hope Bob McDonnell is smarter than Rick Perry. Texas voters should slap Perry out of office, as he single handed-ly made Texas the laughing stock of the nation with his "Deer in the head lights" look when he flamed out in grandiose form. No excuse will fill the void he creates everywhere he goes. His incompetence and ineptness show Texas as single-celled thinkers while everyone else have higher mental abilities. Then Perry hawks his single thought process and opts to negate any additional funding for the people to put forth his skewed thought process. His actions will place millions in peril as their health concerns will flood the ER's around the state forcing Hospitals to increase charges to cover the expenses indigents will not be able to pay. Taxes will go up to cover the increased cost counties hospitals will incur. Every Texan will see increased insurance premiums to off-set insurance expenses. Does McDonnell want the same treatment?
Arnold Smithson July 14, 2012 at 01:32 AM
Bob McDonnell looks to Rick Perry for guidance. Think about that for a minute.
Frances July 14, 2012 at 02:35 AM
I don't live in the USA,but i can tell you without healthcare available to all,you will have a country that has serious mental and physcial health problems.For those who have private health and my family do who live there,it is only because of the jobs they have,but how safe is anyones jobs or homes in this climate,if it came to it.What happens due to no fault of their own,their jobs fold as many have,and how many more jobs are there with healthcare actually available there.what do they do then.I know alot of people who had healthcare insurance over there and it was not all plain sailing,along with that, they still had to had thousands of dollars to their health bill. Both in Ireland and Great Britain when you are working you are paying national insurance stamps towards your healthcare and retirement, out of your wages every week or month.If you are unemployed, even a fee out of that is deducted for these.why is this system not a good idea in the USA.A healthy country is a better country first and foremost.people are your wealth,not gold and silver.
rick barasso July 14, 2012 at 02:43 AM
AS, You said,"Bob McDonnell looks to Rick Perry for guidance". It would be disrespectful to leave out big brother Rick Scott of Florida, who is equally nuts. And keep your eye on a group of GOPs from New Hampshire. They are trying hard to keep up with the antics of the Republicans in the big states.
Arnold Smithson July 14, 2012 at 03:09 AM
My apologies - I didn't mean to leave out any of the other Southern Governors McDonnell plagiarizes his legislative achievements from. The most disappointing part of McDonnell's capitulation to the social conservatives for me was his constant reminders that other states had done it first. He wasn't even innovative in his pandering.
Mike Jewell July 14, 2012 at 04:12 AM
To improve the quality our healthcare system, extend its coverage to all of our citizens and lower total costs as a percentage of GDP over time, we need to do this. Remember, its lowering total costs to the nation public budgets overall that is the desired outcome. If the federal budget rises but national health care costs as a share of GDP declines, we are better competitors in the global market and our people are healthier. So we should opt in.
Mike Jewell July 14, 2012 at 04:13 AM
on Saturday, July 14, 2012 To improve the quality our healthcare system, extend its coverage to all of our citizens and lower total costs as a percentage of GDP over time, we need to do this. Remember, its lowering total costs to the nation public budgets overall that is the desired outcome. If the federal budget rises but national health care costs as a share of GDP declines, we are better competitors in the global market and our people are healthier. So we should opt in.
The Analyst July 14, 2012 at 06:27 PM
What I find interesting is how effective the Republican party's propaganda machine is. Look at all the references and misuse of the term "socialism" in the preceding posts, and the writers are oblivious to it. It's quite remarkable!
Piccadilly Circus July 14, 2012 at 06:45 PM
Obamacare: Seven New Taxes on Citizens Earning Less than $250,000 1) Individual Mandate Tax 2) Medicine Cabinet Tax 3) Flexible Spending Account (FSA) Cap 4) Medical Itemized Deduction Hurdle 5) Health Savings Account (HSA) Withdrawal Tax Hike 6) Indoor Tanning Services Tax 7) Excise Tax on Comprehensive Health Insurance Plans http://www.breitbart.com/Big-Government/2012/06/29/Seven-new-taxes
The Analyst July 14, 2012 at 07:07 PM
I pay for my own health care. Every year in the past the premiums went up until this law was passed. This year my insurance premiums actually went down (not much, but it was --->down<---) for the first time ever. I've also know three people that were, in my opinion, robbed by insurance companies. The purpose of an insurance company is for a group of people to pay into a pool, and when something bad happens, money comes from the pool to cover it. What was happening in the health care industry was the denial of care through the misuse or mis-labeling of pre-exising conditions. People would pay in to the pool, and when they needed money from the pool to cover a problem, a pre-existing condition was used to deny coverage. The pre-existing conditions did not need to have anything to do with the actual problem. Insurance companies would essentially claim they were "defrauded" by the claimants. Insurance adjusters were instructed to scour the records and find any error they could to use against the claimant. The taxes and how much impact they'll have are entirely speculative if not propaganda driven. In spite of the fact that insurance companies still make money under Obamacare, it's not quite the killing they had before (pay into a pool, deny coverage, keep the money). Insurance companies have a lot of money and thus can generate a lot of "facts" to provide their propaganda distributors. Obamacare's working out great for me!
rick barasso July 14, 2012 at 08:02 PM
To Pic, That all sounds like something those crackpots like, Rush, Breitbart and Beck would say. Which is ironic as one is a drug addict, one is dead, one is obviously in need of psychriatric help. What they won't tell you... It will save many lives! Now that may not matter to members of the GOP or Greedy Obdurate Party, But to people with parents and children it should mean something.
Kathy Keith July 14, 2012 at 10:09 PM
To Rick, You may not like it, but Pic's list of taxes is just the beginning. It doesn't matter what his source is, it is true. Do a "google" search for a timeline of the implementation of the ACA and you will find the list of "goodies" to come. Most of the costly items don't kick in for a couple of years. The "goodies" like covering kids to 26, etc. have already kicked in. With all the "free" stuff and perventative test thrown in to the ACA, there are simply not enough doctors and nurses to cover everything. I think that is the big mistake of this bill. They should have written a simple basic plan that given catastrophic to everyone and basic medical care to those who could not afford it. Instead, we have free birth control (even to those who can well afford it.) Cuts to Medicare Advantage are slated to start this year, but adaptations are being offered until after the election so that it won't be noticed. In two years, there will be extreme cuts to Medicare which are not being discussed too much right now. These cuts will affect almost everyone who relies on Medicare for coverage. Rick, I suggest you do your homework. We do need reform, but this bill is a mess.
rick barasso July 14, 2012 at 11:52 PM
To Kathy, Let's break it down: 1."It doesn't matter what his source is", Unfortunately thats a GOP theory. 2."there are simply not enough doctors and nurses to cover everything", Sounds like a "Job Creator" to me and we all know how much the Right likes them.. 3."They should have written a simple basic plan". Well "they" had 60 years, time's up. 4."catastrophic to everyone and basic medical care to those who could not afford it" and the middle class is left out again.The poor already have healthcare and the rich can afford he high deductibles. 5. "Instead, we have free birth control" The scurge of the Left, Unfortunately a weak arguement at best. I love that the right hates birth control at the same time hates helping poor Mothers and children. 6 "Cuts to Medicare Advantage are slated to start this year", why don't you tell us HONESTLY, what those cuts are, possibly things that will be unnecessary under the new healthcare bill? 7."These cuts will affect almost everyone who relies on Medicare for coverage". More fear tactics from the Right. Are you insinuating the left would cut benefits to the elderly? that sounds like a Right Wing plan to me. 8."I suggest you do your homework. We do need reform, but this bill is a mess". Unfortunately for my conservative friends, I do my homework. If you don't like "the mess" tweek it! 9. In the mean time PEOPLE LIVE, not that it matters to the do nothing GOP leadership.
Rob Jones July 15, 2012 at 12:06 AM
Several facts: 1) The cost of healthcare in America is out of control. 2) Those with some level of health insurance typically pay MUCH lower rates for the same level of care or worse as those without health insurance. 3) Millions of employed Americans fail to purchase health insurance every year as provided by their employers (assumption here - they do this because they don't feel like they can pay the premiums because they are too costly or they are young and have little chance of medical challenges - bad mindset to have, but that is all I can come up with to justify that choice). 4) Something needs to be done to provide lower costs for healthcare services and to provide insurance for those that choose not to have insurance or are turned away by insurance providers. Not saying this current law is THE answer, but something does need to be done. 5) No one knows how year 4 of the plan will be paid for once the Federal funds run out. Good guesses include increases in state taxes or cuts to existing programs (has to be one or the other folks). Opting in to this plan does not completely resolve/address items 1-5. Perhaps Gerry Connolly and other representatives for the commonwealth in Congress could educate those in Richmond on what their vision for the state funding in year 4 might be.....
rick barasso July 15, 2012 at 02:26 AM
Mike, Outside of the fact that most of what you've said about the borders and immigration laws in Europe are completely false. Your number of illegal immigrants in the US is about double of any legitimate estimates I have ever seen. Sounds like a continuation of the Conservatve policy of fear and hate. All I hear from the Right is cost, taxes, cost. Why is it they never mention one concern for human life when it comes to healthcare, yet mention a woman's right to choose or birth control and all of a sudden human life becomes paramount... Concerning " the Obama administration's utter failure to help things (stimulus), and our insane national debt". That would be your opinion and nothing more. We were headed for the worst economic disaster since the (decade long)great depression (according to George Bush and every economist) We have had job growth every month since Obama's policies have been in effect, we have 91.8% employment. And I would challenge you or any other Republican to show us mathimaticlly how the looming debt is Obama's fault, It appears he has had the smallest spending increase since Ike! If you can do this, and I'm very confident you will not be able to. I will give you a very simple lesson in economics. PS. What kind of person denegrates someone for helping the most vulnerable people in our communities?
rick barasso July 15, 2012 at 11:44 AM
Mike, Do you really want me to point out all the areas in your last comment that you're wrong or backpeddling? Anyone with the ability to think for themselves and look at FACTS could do it. However, we have learned that those on the Right have no interest in either. Just one example: In your first comment you said, "the influx of some 20 million illegal immigrants" In you second comment you admit "I have seen 10-20 million". I wonder if you can show us where you might have seen the 20 million figure?
Piccadilly Circus July 15, 2012 at 12:40 PM
Deficit by Year 2012 1,333,000,000,000 (projected) 2011 1,229,000,000,000 2010 1,651,000,000,000 2009 1,885,000,000,000 2008 1,017,000,000,000 2007 500,000,000,000 2006 574,000,000,000 2005 553,000,000,000
rick barasso July 15, 2012 at 01:02 PM
PC Nice try, now show us how much of that is due to Obama's initiatives. Don't forhet to subtract for the 2 Bush wars he didn't pay for and the priscription drug plan he likewise didn't pay for.
Piccadilly Circus July 15, 2012 at 01:06 PM
National Debt 7/15/2012 15,871,600,000,000 1/01/2009 10,699,800,000,000 Increase 5,171,800,000,000 A 48.3% increase and six months to go
kmh July 15, 2012 at 01:11 PM
I'm going to "borrow" Jim Lindsay's comment, because he states his support for the expansion so well: Unless you measure success in terms of political strategy rather than actual solutions, it would be insane for the state to opt out of the opportunity to cover a quarter of a million uninsured Virginians for pennies on the dollar. Not only will this coverage save lives, but it would also create jobs and reduce the burden on the insured who are currently paying $1000 annual premium surcharge to cover the cost of emergency care for uninsured , not to mention the current tab the taxpayers contribute to pay for such care. Its time for the Governor to put the interests of Virginians ahead of partisan politics. If we opt out, Virginia will still be paying the taxes that fund the federal payment to states that do participate. How idiotic would that be?
Kevin Chisholm July 15, 2012 at 01:21 PM
The problem of the national debt is one both political parties have cynically played against the American people. Both claiming it an issue; although greedy Republicans raise the din more on this. Still, both parties just “kick the can” further down the road. I truly want to see a smaller, leaner Federal government and give specific ideas on how to get there on my website. I have gotten to know, directly and through colleagues, the Federal bureaucracy very well in my 32 years in Washington. Ironically, I left a state government job to move here in 1981. I have seen more thumb twiddling and non-sense than you would ever believe. It is more prevalent in some agencies than others. If the Republican candidate for President can’t talk about Defense cuts, then he is a huge pretender and phony! What do we need such a huge military for any longer? NO ONE is really asking or answering that question. And what do the major candidates plan to do about a warming climate and unstable earth due to the warming climate. If the supposed leaders of the major political parties can’t discuss the big issues like grown-ups and with honest answers, this country is in for a very dangerous future! Kevin Chisholm Candidate for U.S. House of Representatives (Virginia’s 10th Congressional) www.chisholmforcongress.com
Piccadilly Circus July 15, 2012 at 01:32 PM
Real Unemployment Rate 15% Black Unemployment 15% Black Teen Unemployment 41% Latino Unemployment 11% 766,000 more women unemployed than when Obama took office. College Grad (recent) Unemployment 10%
rick barasso July 15, 2012 at 01:50 PM
OK PC, Your positions have been proven invalid over and over again. And obviously there is no point in trying to educate you any farther. I hope you enjoy tbe "koolaid" while your fellow citizens suffer and die.
Piccadilly Circus July 15, 2012 at 01:52 PM
Estimated Cost of ‘Obamacare’ Is Now $2.6 Trillion — Nearly $1.7 Trillion More Than Obama Promised http://news.yahoo.com/estimated-cost-obamacare-now-2-6-trillion-nearly-042311293.html
Piccadilly Circus July 15, 2012 at 02:25 PM
Huge Fiscal Incentive to Opt Out of ObamaCare's Medicaid Expansion http://www.forbes.com/sites/aroy/2012/07/13/why-states-have-a-huge-fiscal-incentive-to-opt-out-of-obamacares-medicaid-expansion/ Quote, “If you think health care is expensive now, wait until you see what it costs when it’s free.”
Dave July 15, 2012 at 04:10 PM
Not to mention the Bush tax cuts. These factors (the two unfunded wars, prescription drug benefit and Bush tax cuts) account for about 60% of the deficit spending - and they are cumulative. Somehow the irrational right always puts the blame on Obama. Incredible sophistry. At the risk of repeating myself: "The modern conservative is engaged in one of man's oldest exercises in moral philosophy; that is, the search for a superior moral justification for selfishness." John Kenneth Galbraith
REDRUBYBLUEZ August 01, 2012 at 05:28 PM
Virginia officials are always trying to prove a point but the thing is that many people will be able to work if the medicaid limit is $14,000 for income level in which many people who want to get of SSI can do so and then it will help social Security plus it will help many people who cannot afford health care but remember there was going to be a way for people with low incomes to not have to pay for co- pays and Deductables and plus they will have federal help so I say GO FOR OBAMA CARE!!
Anne October 03, 2012 at 01:30 PM
You know, Virginia will likely reject it over a I'm a Republican and Obama is a democrat thing. Rather than look at the reimbursement that Doctors and Hospitals will actually get in their pockets from people who usually have unpaid bills. That means its back in the economy. Mary Washington Hospital will have to stop dumping patients on Inova hospitals and MCV in Richmond. Mary Washington refuses to treat poor Uninsured Americans except to give them pain pills and then they go up the highway. This way, no more dumping.. That alone is worth it to me. Next, we need to insure all people! It's not right that folks die when their illnesses could be caught with regular medical care. Blood Pressure kills people daily and its so easy to treat with yearly medical check ups. Same with Diabetes. Compassion for those less fortunate is what is needed...And there is no excuse at all for poor children to not get regular medical and dental care. NEVER
Anne October 03, 2012 at 03:38 PM
Just like the dems have been and are running calif? LOL Umm hate to tell you but our federal debt is mostly from past administrations and wars. Something not paid for. We are still paying debt from Reagan and you are complaining now? ok George Allen is the spender in Chief of this state dear. All for prisons and life sentences for smoking a joint. Not only that but Allen helped the massive DC debt and had the nads to vote himself four raises. So put the blame where it belongs. on Republicans and Democrats. Not just one party. Ignorance is a mighty sad thing...

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