Sarah Kliff reports on some important and interesting news in Virginia:
Over the weekend, a key committee in the Republican-controlled Virginia House of Delegates backed a budget that would have the state opt in to the Affordable Care Act program to cover low-income Americans. For years now, Virginia Republicans have opposed Medicaid expansion — so this new budget is a significant turnaround….
But the Virginia Republicans’ plan to expand Medicaid comes with a catch. State legislators say it would require enrollees to work in order to receive coverage, similar to new the new programs recently rolled out in Kentucky and Indiana.
There is also movement on Medicaid expansion in Kansas:
Senate Bill 38 to #ExpandKanCare passed the Senate Public Health & Welfare Committee on a unanimous vote! Thanks to all Kansans and #ksleg who support this important health policy. On to the Senate floor! @ExpandKanCare
— Sheldon Weisgrau (@ACAResource) February 19, 2018
From my point of view, any time a non-expansion state is able to expand Medicaid to at least 100% Federal Poverty Level (FPL) should be greeted with cheers. The details always matter, but in my moral universe, improving the lives of those facing great challenges with few resources now is almost always better than causing more pain in the hope that a technically better solution may (or may not) come in several years.
If Medicaid expansion in Virginia needs work requirements, than several hundred thousand people will get coverage that they need and some hassle that they don’t need. That is better, in my mind, than have several hundred thousand people going without coverage and still getting a different type of hassle of trying to manage their medical care with insufficient resources. And once Medicaid expansion is in place, the next task is building majorities to make it and the rest of the healthcare system better.
Matt McIrvin
Work requirements. I guess that’s what comes of losing a coin flip.
Jean
That’s right, Matt. But I agree that expansion is worth the added “work requirement.” Let’s get the expansion and move on from there, hoping we get majorities to make changes where we can down the road.
ThresherK
How long is it til the work requirement comes with a McD’s or Wal-Mart job application stapled to it?
I am for more coverage, and am lucky that my life hasn’t made a job at Wal-Mart a step up, but JFC.
mai naem mobile
Whatever happened to the one VA local race which was decided with the coin flip where th Dem was going to sue?
eric
In the future, it is a lot easier to modify the law to “limit” the impact of the work requirement than it is to pass a medicaid expansion bill without the work requirement. Take the win and make it better after the gaining majorities. Elections matter, and so do people’s lives.
p.a.
How bout the fuckers pass a law that if you already work you have to be provided benefits. I know; Goateed Spock universe.
Feathers
One thing I’ve heard about a work requirement is that it needs to be waived for people applying for social security disability. Apparently that is a good chunk of the non-working recipients and they would really be hurt by a work requirement.
The other issue with work requirements is how do you deal with temporary workers? When I was recently uninsured, part of the issue was that while my overall income was scary low, my weekly income when I was working was higher than allowed under Medicaid. I kept getting interviews for jobs with insurance, so I didn’t follow through on signing up for Medicaid, and then it started again.
Nash
I agree with David that although this is a less than desirable way to increase coverage, it is better than the status quo.
Jeffro
This is a huge win here in VA. That legislature (the Repubs in it, anyway) are batshit nuts. That they are beginning to see the writing on the wall is a major win.
(Plus, now we can point out how stupid and reflexively stubborn they are when they just don’t like a particular Dem – in this case, former Clinton guy Terry McAuliffe. Easy to point out and mock and make sure that independents know who’s trying to actually get something done instead of having a four-year hissy fit)
Jeffro
Oh and David Brooks can absolutely, positively go fuck himself.
boatboy_srq
@p.a.: Ever get the feeling that we’re on the wrong side of that mirror?
boatboy_srq
@Jeffro: I think no small part of that is the isolation of Richmond – although with Lynchburg equally distant (in terms of travel time) from DC/NoVA that’s mitigated a bit.
Shana
@mai naem mobile: She decided not to sue.
A question: aren’t most of the people who don’t currently qualify for Medicaid in VA already working? I think I read that it would be people who make 138% (or thereabouts) of the poverty level, which indicates to me that they’re already working. Am I wrong?
rikyrah
Thanks for the info, Mayhew