9. How does this affect people who aren’t covered by Medicaid?
If Virginia’s government officials decide against the Medicaid expansion, it is not just low-income individuals who will be affected. Timothy Jost, a professor of law at Washington and Lee University and an expert on health care law, said hospitals would be left to grapple with large uncompensated care burdens that would have, in large part, been taken over by Medicaid if the expansion had occurred. Also, an expansion of Medicaid might lead to an influx of dollars for those hospitals, which could lead to more resources and services being offered, said Jost.
According to a study paid for by the Virginia Hospital & Healthcare Association, expansion of the Virginia Medicaid program would mean a $3.9 billion annual boost for the Virginia economy. The study also concluded that more than 30,000 jobs, many of them in the health care sector, could be created as a result of the influx of federal dollars that would come with a Medicaid program expansion.
The Affordable Care Act was originally billed as a plan that would make health insurance coverage possible for all Americans. However, if a state such as Virginia chooses not to expand its Medicaid program, some people will slip through the cracks and remain uninsured under the law.
Jost said if Virginia does not expand its Medicaid program, any residents in the state with incomes below the federal poverty level who do not already qualify for Medicaid would continue to be uninsured under the Affordable Care Act. That means they would be forced to turn to emergency services for medical care, said Jost. The Rockbridge Area Health Center is another option for uninsured area residents. Some of those people will likely make too much to qualify for Medicaid under the old requirements, yet not enough to purchase federally-subsidized health insurance through the new state health insurance exchange, which will open in October.
Business owners with 50 or more employees who don’t offer employee health coverage would also be affected. They would have to pay a fine if even one of their employees gets coverage from the state health exchange. If the employees had been covered by an expanded Medicaid program, the penalties wouldn’t apply, said Jost.
People making more than 100 percent of the federal poverty level will be affected as well.
“For adults with incomes between 100 and 133 percent of poverty who would be covered by Medicaid under the Medicaid expansion, they will be eligible for premium tax credits but … will certainly face higher premiums and also higher cost sharing than they would face under Medicaid, so they will be worse off as well,” said Jost.
10. What is a health insurance exchange?
Before people purchase something big like a car or a vacation, they might shop around a bit to try to find the lowest price for the product they seek. This is the idea behind the new health insurance exchanges. According to HealthCare.gov, the exchanges will offer residents in each state a chance to compare insurance policy offerings and prices. The federal government will offer tax credits to some individuals to help make the insurance policies more affordable, depending on income level. The exchanges are scheduled to open in October.