The News Desk is a collection of news, notes and breaking items affecting the Fredericksburg community.
State’s Medicaid reform panel weighs expanding coverage
RICHMOND—The chairman of Virginia’s Medicaid reform panel wants to see a “Virginia plan” for how to expand health coverage to the poor.
“I fully intend, from the education that we’ve gleaned . . . for us to develop with staff some semblance of a Virginia plan to move forward,” said Sen. Emmett Hanger, R–Augusta.
Hanger was speaking at the end of a four-hour state Medicaid Innovation and Reform Commission meeting in Richmond Monday.
Much of the commission’s time was spent hearing presentations on ways some other states are approaching Medicaid expansion or seeking waivers for more market-based ways of helping low-income people receive health coverage.
Medicaid expansion is a controversial topic in Virginia. Some say the state should expand to help the neediest people get care, while others worry that the federal government can’t afford to live up to its promises to pay for it.
The expansion proposal is part of the federal Affordable Care Act. That law allows people with incomes between 100 percent and 400 percent of the poverty level to receive tax subsidy help with paying for health insurance premiums, but people with lower incomes don’t qualify for subsidies because the law intended that they’d be covered by expanded Medicaid eligibility in the states.
However, the Supreme Court ruled that states didn’t have to expand Medicaid, and half the states—including Virginia—have not done so.
Virginia set up the MIRC, a legislative panel that is reviewing the state’s efforts to get federal permission for various reforms to the Medicaid program and will decide whether, based on those reforms, Virginia should move forward with expanding Medicaid eligibility.
State Secretary of Health and Human Resources William Hazel told the panel Monday that technically, the Department of Medical Assistance Services could argue that Virginia had made good progress on some of those reforms.
The state is moving forward with a streamlining of services for people who are dually eligible for Medicaid and Medicare and other reforms, he said.
“If pushed today, DMAS could arguably say it has now met all the requirements in the budget,” Hazel told the panel. “I think we still probably have a ways to go before I’m ready to agree with that statement. . . . Some of these reforms you can’t do unless you do expand. It’s a chicken and egg situation. . . . [But] I think you can argue with a straight face that we’ll get there.”
Hanger, who generally supports the expansion, said after the meeting that he thinks the state’s work on those reforms is a success.
“They actually have accomplished a lot that we asked them to do,” he said.
But politically, Hanger acknowledged, it’s a different story. He said he hopes to find a way for Virginia to expand coverage that would sidestep some of the political objections to expansion.
Hanger wasn’t very specific, but he did offer an example—he wants to find ways to address potential provider shortages.
Hanger said that after next month’s statewide elections, he plans to push back against “misinformation” that he said has been spread in Virginia, particularly by Americans for Prosperity.
That’s a national group that has taken an interest in Medicaid expansion in the states, lobbying heavily against it, particularly in Hanger’s district.
Hanger said he disagrees with AFP’s goals, and doesn’t want to get rid of the Affordable Care Act.
“We need to improve upon it, rather than destroy it,” he said.
The MIRC will meet again at least twice before the General Assembly’s 2014 session starts in January, although the next meeting time has not yet been set.
Meanwhile, President Barack Obama gave a White House Rose Garden speech on Monday in which he admitted there was no “sugarcoating” the fact that countless people have been unable to sign up for new marketplace insurance because of widespread healthcare.gov website problems.
He said the site has had nearly 20 million visits since open enrollment started Oct. 1, which proves there is great interest in what the Affordable Care Act offers: “quality health insurance that’s affordable.”
“The product is good. The health insurance that’s being provided is good. It’s high-quality, and it’s affordable,” Obama said. “People are rushing to see what’s available, and those who’ve already had a chance to enroll are thrilled with the result.”
Opponents of the law were quick to counter Obama’s statements that the Affordable Care Act was “more than a website” because key provisions, such as the requirement that preventive care be covered without a co-pay and that insurance companies no longer be able to deny coverage to those with pre-existing conditions, have already kicked in.
“ObamaCare’s problem is larger than a website failure, and it will take more than a ‘tech surge’ to fix it,” Rep. Eric Cantor, R–Va., said in a statement. “The website does serve as stark evidence that the federal government is ill-equipped to centrally manage our nation’s health care.”
Yet Obama called for patience.
“I want everybody to remember that we’re only three weeks into a six-month open enrollment period when you can buy these new plans,” he said. Coverage under any marketplace insurance is set to begin no earlier than Jan. 1, and enrollment is open until March 31.
“Everybody who wants insurance through the marketplace will get it,” he said.
Also, Obama said technology “experts” are working overtime to address website glitches.
“We are confident that we will get all of the problems fixed.”
Free Lance–Star Healthy Life Editor Donya Currie contributed to this report.
Chelyen Davis: 540/368-5028