RICHMOND, Va.- Virginia’s Medicaid program stands to lose $1.8 billion over a six-year span under House Republicans’ plan to overhaul the nation’s health care system, a state analysis has found.
The office of the Secretary of Health and Human Resources released a summary of the analysis to The Associated Press late Friday afternoon. It found Virginia’s program would see the steep cuts because the Republican plan makes fundamental changes in the way the federal government funds its portion of Medicaid, the public health insurance program for the poor.
Democratic Gov. Terry McAuliffe told AP the Medicaid changes would force Virginia to either raise taxes to pay for health care benefits or kick vulnerable people off of Medicaid, which he says amounts to a “death sentence” in some cases.
The governor called the proposal Donald Trump’s “crazy plan” and said, “He has put Virginia in a very untenable position.”
As introduced, the proposal would end Medicaid’s open-ended entitlement status, moving in fiscal year 2020 to a system of limited federal financing. Washington would pay the states a fixed amount per beneficiary, based on 2016 Medicaid spending in each state, adjusted for medical inflation.
According to the summary of the analysis conducted by the Department of Medical Assistance Services, Virginia’s per-enrollee costs are expected to be higher than the per-enrollee allotment through the medical inflation tool. The Medicaid program would lose the $1.8 billion between 2020 and 2026, the analysis found.
Virginia already has some of the strictest Medicaid eligibility standards in the county, and it ranks 47th among other states in terms of per capita Medicaid expenditures.
“This proposal to end the Medicaid program as we know it would lock Virginia into the very lean and mean program that we have currently into perpetuity,” Michael Cassidy, president and CEO of The Commonwealth Institute, a Richmond-based fiscal policy analysis group that focuses on issues that impact low-income and middle-class people, said in an interview earlier this week.
McAuliffe has tried unsuccessfully his entire term to convince Republican lawmakers who control the General Assembly to expand Medicaid coverage to able-bodied, low-income Virginians.
The federal government had pledged under Obama to pay the bulk of the associated costs, but Republicans said its long-term costs were unsustainable. Virginia and 18 other states refused the expansion.
The House plan is far from finalized. In a report this week that prompted many GOP lawmakers to emerge as opponents, the nonpartisan Congressional Budget Office said the legislation would leave 24 million people uninsured in a decade, including 14 million next year, and boost out-of-pocket costs for many.
Sen. Emmett Hanger, a Republican who co-chairs the Senate Finance Committee, said Friday that the governor’s predictions of higher taxes or a reduction in services were premature.
He said that while the picture so far isn’t good for Virginia, it also doesn’t seem like the GOP plan as proposed was gaining much traction in Washington.
“I don’t think it will be easy for Congress … to push through something that will be seen as devastating to the states,” Hanger said.