RICHMOND — As Virginia legislators continue to debate whether to expand Medicaid under the Affordable Care Act in the state’s two-year budget, some Medicaid expansion supporters claim more than 25,000 Virginia veterans and their spouses could receive health care coverage if the General Assembly allows expansion.
In March, hundreds of people gathered at the Virginia State Capitol to rally in support of Medicaid expansion.
Mercedies Harris, a former Marine from Waynesboro, Va., spoke at the rally.
Harris, who does not have health care coverage and would benefit from Medicaid expansion, told the crowd he has glaucoma and struggles to pay more than $400 a month for his medication.
“Like all veterans, I was proud to serve our country,” Harris said. “So I’m asking you to please don’t turn your backs on us now. We have a shared responsibility to protect and expand opportunity for this generation and for the future generations. The time is now to close the coverage gap.”
Massey Whorley, a senior policy analyst for The Commonwealth Institute of Fiscal Analysis, co-authored a report called “Left Behind,” which explains the benefits of Medicaid expansion for Virginia veterans.
Whorley said Virginia currently ranks 48th in per-capita Medicaid spending.
“Virginia has one of the stingiest Medicaid programs in the country,” Whorley said. “It is just hard for adults to get coverage in Virginia to begin with.”
According to Whorley, veterans health benefits are not guaranteed for all veterans because veterans must have incomes below a certain level, serve for at least 24 months and be honorably discharged to be eligible for VA benefits.
Whorley also said it can be difficult for veterans who have faced traumatic situations abroad to navigate the application process to receive VA benefits.
“They come back and they have a whole host of mental issues they are working through,” Whorley said. “And when you’re dealing with those kinds of things, it can be very hard to navigate a bureaucratic process like the VA benefits enrollment program. I think that makes it all the more necessary for that person to get that care they need. So they’re not living on the streets, and they can contribute and really move ahead.”
Whorley said veterans can face mental issues, such as post-traumatic stress disorder, which can lead them to be dishonorably discharged and not be eligible for VA benefits.
Veterans who are eligible for VA benefits still can struggle to receive medical care because there are only three VA hospitals in the state, Whorley said.
Although there are outpatient clinics in Virginia where veterans can receive some VA benefits, Whorley said VA health options still are limited for Virginia veterans, who may have to travel 50 to 75 miles to be treated at an outpatient facility.
“That is no substitute for having access to a primary care physician in your community,” he said.
Medicaid expansion also would help Virginia’s veterans receive preventative care, Whorley said.
According to the report, more than 41 percent of veterans without coverage communicate that they have untreated health needs, and more than a third delay receiving care because of the cost. The report also states that slightly more than 12 percent of veterans with coverage have untreated health needs.
“Veterans who don’t have health coverage, they often go without the care they need,” he said.
Whorley said Medicaid expansion also would benefit the spouses and dependents of Virginia veterans. The dependents, he said, only are eligible for VA benefits under certain circumstances, such as when a veteran dies in the line of duty or becomes permanently and totally disabled.
“We’re talking about really severe cases for the spouse and dependents to (currently) qualify,” Whorley said.
According to the report, more than half of veterans’ family members without coverage have untreated health needs and 44 percent delay care because of cost.
Sean Lansing, the Virginia state director of Americans for Prosperity — an advocacy group that promotes the individual right to economic freedom — says expanding Virginia’s Medicaid program would be unwise.
“We’d be doing a disservice to the most vulnerable citizens in Virginia if we double down on a policy we all know is failing,” Lansing said. “We think it makes sense to take a look at the program, find out what works, find out what doesn’t, and then learn how we can best deliver health care to the people who need it most.”
According to Lansing, the federal government will not be able to provide the promised funding for Medicaid expansion in Virginia because the federal government is currently more than $17 trillion in debt.
“I have no faith in the ability of the federal government to keep writing checks to Virginia for billions and billions of dollars when they can’t even balance their own budget,” Lansing said. “I think it’s disingenuous of the other side to argue that there’s free money just lying around for the taking. There’s obviously no such thing as free money.”
Lansing said he and many others do not believe the federal government will fund the commonwealth’s Medicaid program for three years and fund 90 percent of the program after the three year period ends.
“Time and time again, all sorts of government programs, especially at the federal level, start out with good intentions but then, a couple years down the road, somebody has to pay for it,” he said. “A couple years down the road, this program, by expanding it blindly, is going to cost likely billions of dollars.”
If the General Assembly does not determine a budget by July 1, the Virginia government will shut down.
Lansing said a government shutdown will have a “devastating impact” on the commonwealth, including on the quality of public education and public safety.
“If the governor and those 23 state senators continue to hold the budget hostage over Obamacare and continue to threaten a shutdown,” he said. “It’s going to have a horrible impact on our local governments. It’s going to have a horrible impact on our schools. And it’s going to have a horrible impact on our communities.”