The newly passed federal budget bill is expected to have major impacts, including to our health and wallets. For example, last week the Virginia State Corporation Commission (SCC) reported a projected increase of 20.5% in premiums for Affordable Care Act Marketplace coverage. I have seen other estimates of increases up to 75%. Wow. The SCC further projects that the increased cost will price out about 135,000 Virginians from this insurance. Without health insurance, minor ailments are more likely to be tolerated, even if the consequences impact both health and the economy (e.g. not having access to medication to control blood pressure). Reducing prevention leads to a less healthy population, and to greater medical expenses for everyone. Hospitals will still be required to treat serious medical conditions (including those that could have easily been treated while minor!) The greater demand for unreimbursed care on hospitals simply means that some will either need to shut down (if they are no longer financially viable), or if they will need to raise increase funding from somewhere else (e.g. increase their rates.) We also should expect more cases of flu, greater potential for our children getting measles (and adults too!), and other transmittable diseases (including Covid) hurting our population and our economy. Prevention – which typically depends on health insurance – is simply much cheaper than treating illness. Yet, our new health insurance policies will be working in the wrong direction.
For many on Medicaid, the situation appears dire. Best estimates are that about 630,000 Virginians will lose coverage, with the removal of coverage scheduled to begin in October 2026 (no real reason has been given for the delay of more than one year, although regularly discussed is that it is being done to minimize the negative response to this loss of Medicaid on the 2026 elections.) Many people are expected to lose coverage simply because the paperwork and reporting requirements will be increasing substantially. It’s somewhat ironic that even as Virginia adopts the use of AI to streamline government, the new Medicaid requirements will add so much paperwork that eligible people will not be able to negotiate through the bureaucracy.
Local services can help respond to these changes, although, of course, they would require resources to add services to their ongoing responsibilities. For example, help should be vital in enabling people still eligible for Medicaid to navigate through the paperwork process. Locally, such help could come from government social service agencies or health departments, or community organizations such as churches, schools or a variety of citizen groups. More difficult may be responding to a decrease in health in our communities. Will more sick kids be in our schools – or will more sick kids be home alone as their parents need to work? These are real issues, and preventing these situations has been an important contribution of Medicaid. Our community needs to move forward aggressively to counter these losses to the medical system – which of course requires both time and money. Will local and state governments rise to successfully meet this new challenge? We have time before these changes to our health system take effect. Let’s hope this time is used effectively in generating responses that keep our communities healthy. It would be great to hear from our local politicians and candidates about their ideas for helping our community meet these new challenges.
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