Healthcare For All Virginians 2017 Platform
Tuesday, January 24th, 2017
HEALTHCARE FOR ALL VIRGINIANS
VPLC is part of the Healthcare for All Virginians coalition and below is the coalition’s 2017 Platform.
Both President-Elect Trump and the Republican Caucus in Congress have promised to drastically change many of the health programs that millions of Americans rely on. In addition to plans to “repeal and replace” the Affordable Care Act (ACA), there are threats to Medicaid, Medicare, and CHIP (Virginia’s “FAMIS” program).
While only some details are available now, the Healthcare for All Virginians (HAV) Coalition is planning to actively engage at both the state and federal levels and continue to pursue the Mission and Guiding Principles we established in 2009.
As the new healthcare landscape unfolds, HAV will be engaged to:
(1) Prevent cuts to existing health programs; and
(2) Promote needed improvements.
Here is a brief description of the issues HAV will address in 2017. More details and analysis will be provided as the debate over these issues unfolds.
Medicaid – Oppose cuts to current eligibility levels, services, and provider reimbursements.
- About 1 million Virginians are enrolled in Medicaid, primarily children, pregnant women, parents, seniors over the age of 65, and people with disabilities.
- Despite its size and cost, overall, Virginia’s program is very restrictive, ranking 47th in the country for per capita Medicaid spending.
Medicaid – Support broader coverage for low-income adults, including low-income parents, and people with substance use disorders and mental illness.
- Use Medicaid expansion funding to the extent the option remains available.
Since 2014, Virginia has refused to expand coverage to very
adults. Without expansion, parents must have income below 50% of the poverty line (FPL) to qualify; childless adults (who aren’t pregnant, elderly or disabled) cannot qualify no matter how poor they are.
- The current Medicaid waiver for people with serious mental illness has limits on eligibility and covered services. Without access to healthcare,
uninsured adults with mental health and substance use disorders often end up in the criminal justice system.
Safety Net Programs – Support community health centers, free clinics and community services boards which continue to serve Virginia’s uninsured.
- About 750,000 Virginians remain uninsured, and safety net programs cannot meet this need.
- 50% of the patients served by Community Services Boards are uninsured.
Affordable Care Act – Oppose repeal without simultaneous “replacement”.
- Replacement must ensure affordability and quality of insurance plans and include consumer protections (e.g. provide coverage of pre-existing conditions, no annual caps, and free preventive services.)
- About 400,000 Virginians currently have ACA Marketplace insurance; most (84%) qualify for tax credits to help pay their premiums; and 220,000 also have reduced cost-sharing because their income is under 250% FPL.
Medicaid – Oppose “block grants” or “per capita caps”.
- Those changes would shift costs to states and hamper their ability to improve programs and respond to changing demographics, economic circumstances, and medical innovations.
- Because of Virginia’s restrictive eligibility and refusal to expand Medicaid, the state could be at a great disadvantage if such restructuring was enacted.
CHIP/FAMIS – Support reauthorization of the CHIP program for children and pregnant women.
- This program is due to expire in 2017.
- About 110,000 children and pregnant women rely on this program.
Medicare – Oppose proposals to turn Medicare into a private voucher program or to allow people to opt out.
- Such proposals will end Medicare and turn it over to the private insurance industry.
- Analysts conclude this would drastically increase out of pocket costs for the elderly and disabled.