Loudoun County's pro-business Board of Supervisors is dismissing calls from area business leaders to expand Medicaid coverage in Virginia.
While the Loudoun County, Fairfax County and Greater Reston chambers of commerce, the American Association of Retired Persons and local hospitals have all supported the Medicaid expansion, the all-Republican Loudoun board voted unanimously in early February – with the exception of an abstaining Janet Clarke (R-Blue Ridge) – not to endorse the expansion in healthcare coverage.
This opposition came despite a briefing from Assistant County Administrator John Sandy who shared the potential benefits the expansion could have on Loudoun.
While the decision-making power of the Medicaid debate falls on state legislators in Richmond, the Loudoun supervisors felt compelled to chime in on the issue.
If the commonwealth opted into the extension in Medicaid benefits, Virginia would receive $20 billion in federal funding for an investiture of $150 million in state funds, according to Sandy, who serves partially as a liaison between the Loudoun board and state lawmakers.
According to the Commonwealth Institute, the expansion would insure 400,000 additional Virginia residents and create approximately 30,000 jobs, Sandy said.
The Fairfax Chamber of Commerce commented on the expansion: "Coverage extension paired with reform is a good deal for Virginia – for every penny the commonwealth spends on extension over the next decade, Virginia receives $1.73 back from the federal government.”
Virginia's Medicaid program is currently among the most restrictive in the U.S. The new income eligibility would extend benefits for people at 138 percent of the Federal Poverty Level, which amounts to approximately $15,000 per year for one person and $32,000 for a family of four.
The federal government would provide 100 percent funding for the expanded Medicaid in the first three years and it then would be reduced to 90 percent in the ensuing years.
Also supporting some form of Medicaid extension are Inova and Hospital Corporation of America hospitals, who claim it will help alleviate costs for both the indigent and a greater share of uninsured patients who often utilize emergency rooms for their primary care solutions.
None of these facts were wooing Loudoun's supervisors, however.
Supervisor Suzanne Volpe (R-Algonkian), who made the motion for the board to not support the expansion, doesn't believe the federal government will follow through on its funding promise.
“I'm concerned about the strings attached ... I feel like a carrot is being held over our head,” Volpe said.
Volpe's colleague Eugene Delgaudio (R-Sterling) asked Sandy if he could promise him opting into the program wouldn't cost more than is planned.
Sandy said the way the law is written provides for that.
“It's money that will be available to states that wish to opt in,” Sandy said. “What we're trying to point out is that there are some potential savings for Loudoun specifically, related to inmates who are subsidized under this.”
As of Feb. 19, just three days before the end of the 2013 General Assembly session, legislators had not finalized bills on the Medicaid expansion.
State Sen. Barbara Favola (D-31st), who represents a portion of eastern Loudoun County, led the effort to expand Medicaid throughout the 2013 session.
She said many citizens who would benefit from the expansion “are currently getting care at our emergency rooms, and we are all paying the price through higher premiums.”
"This care is delivered at the most costly point and patients are getting the worst outcomes,” Favola said earlier this month. “Moreover, $5 million a day in federal tax dollars from Virginians will go to support the expansion in other states, should we fail to approve this expansion."
Republican Gov. Bob McDonnell has previously expressed opposition to the Medicaid enhancement. Like Volpe, McDonnell said he doesn't believe the federal government can afford to provide Medicaid for the additional pool of citizens.