Virginia Seeks Medicaid Expansion Alternative

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In Virginia, the debate over Medicaid expansion and reform may be a win-win situation, regardless of its outcome.

In Virginia, the debate over Medicaid expansion and reform may be a win-win situation, regardless of its outcome. This is due in part to a state senate decision that would insure an additional 400,000 low-income individuals, and pay out millions of dollars a year to private insurers. Even if the decision fails, Medicaid reformation efforts would still shift many current Medicaid beneficiaries into managed care organizations (MCOs). Private insurers who sponsor plans within MCOs would benefit.

“It’s the best of times for managed care because both sides are calling for us,” said Doug Gray, executive director of the Virginia Association of Health Plans.

In 2013, nearly half of the $2.6 billion spent on managed care went to consumers covered under WellPoint and Aetna health plans. Both organizations participate in MCOs in order to capitalize on expanded Medicaid coverage.

“We believe it’s a service that adds value, that’s why we’re willing to pay for it,” says William A. Hazel Jr, MD, Virginia’s secretary of health and human services. He added that the ongoing discussions and debate about Medicaid reform has accelerated the transition of beneficiaries to managed care settings and plans. “It made it a lot more critical,” Dr Hazel said.


Virginia is one of several states that’s using private insurers as a way to make Medicaid expansion possible. Some conservative policy makers remain resistant to Medicaid expansion because it is tied to the Affordable Care Act.

Reform is important for its state residents. A recent study found that not expanding coverage would lead to premature deaths due to otherwise treatable medical conditions. While some of the poorest are already covered, and many are buying insurance, there are those who fall into the coverage “gap” in between.

“It is irresponsible to leave billions of dollars on the table and hundreds of thousands of Virginians uninsured. It is time to put aside the partisan warfare focused on making our President and our Governor look bad at the expense of our citizens. It is time to practice common-sense governing and reach agreement on this vital issue that can dramatically affect the health and wellbeing of 400,000 fellow Virginians,” said Congressman Gerry Connolly (D-VA).

Around the Web

Medicaid Expansion Debate Good for Insurers

[The Washington Post]

Virginia Is Broken [Slate]

Rep. Connolly Urges Virginia General Assembly to Close Medicaid Gap

[Blue Virginia]