Though state legislators have not voted to expand Medicaid coverage, one state Senate committee has submitted an alternative way to provide coverage to as many as 400,000 poor residents.

Dubbed Marketplace Virginia, the plan would take the yearly $1.6 billion available for Medicaid expansion and use it to fund private insurance plans for the uninsured. The plan was approved by the state Senate Finance Committee, but no vote has occurred on the bill.

State Sen. Bill Stanley said he reviewed the bill, but had several objections to the way it worked.

“It’s rushing into a program that may not work,” he said.

Stanley explained that the bill — like an expansion of the Medicaid program — would still accept federal funds to pay for health coverage. The senator said he worried the federal government would not hold up its multi-year promise to fund the program.

“You don’t offer something to someone and pull it away from them,” he said.

Of course, the General Assembly is no stranger to accepting federal tax dollars to fund state programs. The Virginia Department of Transportation even accepted $52 million in additional funding from the federal government to service state highways in 2012.

Still, news from the governor’s office yesterday signaled future problems ahead for the state budget. Gov. Terry McAuliffe said he expected a budget shortfall for the two-year budget to be $2.4 billion — about $882 million more than expected. The state budget covers until July 30, 2016.

If the Marketplace plan is passed, the state would allow a private broker to enroll patrons in health plans and negotiate monthly premiums with insurance companies. Danville PATHS CEO Kay Crane said the plan might work — if premiums were not too expensive for patients.

“It’s got to be cost-efficient for people to afford it,” she explained. “It’s going to come down to ‘Can they afford the premium?’”

Crane said patients also needed a plan that covered everything from primary care visits to hospital stays and specialty treatment. Right now, PATHS sends many of its Medicaid patients who require specialty care more than 100 miles to the University of Virginia hospital — one of the few to accept Medicaid in the state. Stanley said 38 percent of doctors in the state do not accept Medicaid.

Crane stressed that lives were at stake in this fight.

“One thing I would challenge senators is to remember why we voted for them,” she said. “I would challenge them all to find a plan. I would challenge them all to act with urgency.”

Stanley said he was still working to find a solution to the issue and had already introduced seven pieces of legislation to the House. He also plans to visit more clinics in the state in September to hear about issues faced by staff and patients.

“I want to start the conversation about the options available to us,” he said.

Along with thinking about the uninsured, the senator said he wanted to help out hospitals losing federal funds due to the Affordable Care Act. The General Assembly chose not to access those funds by not approving Medicaid expansion.


(Posted: Monday, August 18, 2014 6:15 am at