Dive Brief:
- Gov. Terry McAuliffe's (D) goal for Medicaid expansion next year could get an extra boost if Democrats pick up a Senate seat to gain control.
- If Virginia expands Medicaid under the ACA, up to 400,000 Virginians with incomes up to 138% of the federal poverty level could gain coverage, and the state could receive $14 billion in federal funds by 2022, according to the Urban Institute's estimates.
- Gov. McAuliffe said in an email interview with Modern Healthcare failing to pass Medicaid expansion would hurt hospitals, especially rural ones. "It will also be a missed opportunity to create jobs, increase budget revenues and build a healthier workforce. I am going to continue to make the case, and hope leaders in the General Assembly come to the table so we can do the right thing in the best way for Virginia."
Dive Insight:
Both chambers of the Virginia General Assembly are up for election for a total of 140 seats. The 12th Senate District, which includes Richmond, is where the Medicaid debate is heating up. Dr. Siobhan Dunnavant, a Republican against the expansion is facing off against Deborah Repp, a registered nurse and Democrat who supports it. They are both hoping to fill the seat left by retiring Sen. Walter Stosch, only one of the three State Republicans who supported a private-plan Medicaid expansion last year.
The Virginia Hospital & Healthcare Association launched a big media campaign last week to highlight hospitals' key role in the state economy, financial struggles of it members and the required legislative relief. It reported one-third of the state's acute care hospitals had negative operating margins in 2013. In rural Virginia, 17 of 37 hospitals operated in the red. Things are expected to get worse with the federal budget sequestration cuts requiring a continuous 2% drop in Medicare payments.
Health system CEOs at the association's news conference warned a lack of legislative relief could result in service cuts, layoffs or even hospital closures. Mark Merrill, CEO of Valley Health said it may close its trauma center in western Virginia, forcing people to go to West Virgina for trauma care.
Democrats only need to gain one seat in the Senate for a 20-20 split that would throw the tie-breaking vote to Lt. Gov. Ralph Northam (D). This would put Gov. McAuliffe in a stronger position to push Medicaid expansion through, but it would still face strong opposition in the House, according to Stephen Farnsworth, a political science professor at the University of Mary Washington in Fredricksburg.