As part of the “One Big Beautiful Bill Act,” sweeping tax reform and spending policy changes are set to occur at the federal level. For those concerned about what these changes may mean for Virginia’s Medicaid expansion, I want to lay out some general facts that may help put you at ease.
First and foremost, Virginia’s Medicaid expansion is not ending. Rather, it is being reformed to ensure sustainability, integrity, and fairness. The legislation keeps the 90% federal match intact, strengthens coverage for the most vulnerable among us, cracks down on fraud and abuse, and restores the original promise of work-oriented eligibility. The federal legislation does not cut Medicaid – it saves it from collapse. The bill eliminates waste, restores accountability, and protects care for those who need it the most.
Medicaid was designed for pregnant women, children, the disabled, and low-income seniors – and this bill doubles down on them. Expanded are Home & Community Based Services, and an additional $50 billion is invested in rural care through the new Rural Health Transformation program. This bill stops paying Medicaid benefits to people with million dollar homes, people who are enrolled in multiple states, and people who are illegal immigrants or unqualified enrollees. Virginia’s Medicaid program will return to what it was originally meant to be – expansion with a work requirement for the able-bodied. To continue to be eligible for Medicaid, enrollees must complete 80 hours per month (20 hours per week) of work, training, education, or volunteering. Seniors, the disabled, caregivers for children under 14 years of age, pregnant women, and the medically frail are all exempted from this requirement.
Some Virginia Democrats have been citing a misleading statistic, stating that there are between 300,000 and 322,000 Virginians whose health care will be “at risk.” Roughly half of that misleading number refers to able bodied working adults – without dependents – on Medicaid who are not willing to work, go to school, or engage in the community through volunteering.
When work requirements were authorized in Virginia in 2018, the Joint Legislative Audit and Review Commission (JLARC) estimated that only 7% of the Medicaid expansion population would choose not to comply with the work requirements. Today, that would equate to 42,000 individuals.
The other half of that misleading statistic refers to people who will choose to not participate in the state’s Obamacare exchange at a higher premium. If someone drops their Obamacare insurance coverage or refuses to do the basic community engagement work, they are not really being “kicked off” of anything. With rampant federal debt and deficits growing out of control by the day, President Trump and the U.S. Congress must make decisions on spending that are fiscally sound without negatively affecting those among us who are the most vulnerable. Tackling waste, fraud, and abuse in our entitlement programs – while ensuring that those who need them still have access – is the desired outcome.
As the Delegate representing the 42nd House District in the Virginia General Assembly, your concerns are my greatest priority. If ever I may be of assistance to you and your family, please do not hesitate to reach out to me at DelJBallard@House.Virginia.Gov. You can also follow me on Twitter @JasonBallardVA or like my Facebook page, Jason Ballard for Delegate, to keep up to date with what I am doing in Richmond and in our community on your behalf.
