State Sen. Bill Stanley recently spoke at both DRMC and Piedmont Access to Health Services, seeking input from staff on how to help those uninsured and not covered by Medicaid.

In Virginia, about 400,000 people earn too much to qualify for the current Medicaid program but do not have health insurance. About 3,500 of them reside in Pittsylvania County, according to Centra CEO E.W. Tibbs Jr.

“It’s a gap, and these are working people who need insurance,” Deaton said.

Last spring, following the passage of the Affordable Care Act, about $1.6 billion became available to Virginia to expand the program to the uninsured. However, Virginia is still one of 21 states not accepting expansion funds. Delegate Danny Marshall said the refusal of funds represented a concern for the state budget.

“If you look at the state budget, Medicaid is the second highest cost,” Marshall said. “It’s the fastest growing line-item of the budget.”

Marshall said he and other delegates were worried about having to cover the $1 billion with state funds if the federal funds fell through.

“The problem is what happens if they don’t live up to their word,” Marshall said.

Deaton said taxpayers in the state still had to pay for Medicaid expansion in other states, and the cost of the program could be easily recouped.

“The big issue for me is we take federal money for other things throughout the state,” he said.

Virginia accepted about $136 billion in federal funding in the 2010 fiscal year, according to the Census. Per capita, the state took in $17,000 and was second only to Alaska.

During Stanley’s Monday visit to PATHS, he told attendees only about 270,000 people, not 400,000, could be covered by an expansion, saying he believed many had insurance from their workplaces.

Regardless of the number, PATHS CEO Kay Crane said the decision to expand is a no-brainer.

“It’s a human thing,” Crane said. “There are faces to these numbers. They have got to get that.”

Crane said many of the patients who could not afford care suffer from long-term medical issues like high blood pressure and diabetes, and only saw a doctor when a health emergency occurred.

During his talk with PATHS, Stanley suggested several state-funded alternatives to expansion, including a focus on preventative care and more state funding to community heath centers.

“He’s got to do more than come up with a plan,” Crane said “We need action.”

Deaton said expanding coverage would not only benefits patients, but let the hospital provide better services to the community.

“It really does help, and it helps other businesses as well,” he said. “A healthier workforce is a better workforce.”

When delegates head back to work in September, they will already have an alternative plan to discuss. Dubbed Marketplace Virginia, the plan lets people purchase private insurance with state-subsidized premiums. The plan would be funded from the federal money offered to expand Medicaid coverage.

No matter what the solution entails, Deaton said his staff is ready to work with Richmond.

“We are very open to working with them, and we think it’s very important to get more coverage for our citizens,” Deaton said.