Frank Wagner: Health plan could help 2 million Virginians
As we in the General Assembly close in on a budget deal, the significant obstacle that remains is whether to expand Medicaid to include as many as 400,000 Virginians, most of whom are currently without health insurance.
Traditionally, Medicaid has been an entitlement program that provides free health care to the neediest individuals, including children, as well as adults who are aged, blind, disabled or pregnant. The expansion of Medicaid under the Affordable Care Act would cover everyone with incomes below 138 percent of the poverty level, individuals who are considered to be the working poor.
But what about those who earn income above that threshold ($16,753 for a single individual and $34,638 for a family of four)? These hard-working Virginians struggle every day to cover their health insurance, deductibles and co-pays while trying to meet the rest of their living expenses.
I believe we can and should help both groups of Virginians.
The House of Delegates’ budget includes $307 million in provider assessment fees. These fees will be paid by the hospitals. Because 400,000 uninsured Virginians will now be eligible for coverage, the hospitals will be reimbursed for health care services they currently provide for little to no payment. Many hospitals have agreed to this fee. While most hospitals in Virginia are “nonprofit” businesses, these not-for-profit hospitals are some of the most profitable companies in the state.
Based on their filings with Virginia Health Information System, the combined “profits” of the five largest hospital systems in Virginia were more than $1.1 billion in 2016 — without any new money flowing from Medicaid expansion. Clearly, $307 million collected from a new provider assessment will not harm the hospitals’ financial posture.
What if, as part of Medicaid expansion, we took $150 million of the $307 million in provider assessment fees and put that money back in the pockets of those hard-working lower- and middle-income families who have health insurance, but are struggling to pay their medical expenses?
Presently, 660,000 Virginians a year file tax returns showing adjusted gross incomes of $30,000-$50,000. If we provide a tax credit of $250, the total cost to the state budget would be $165 million.