The gap in health insurance coverage created by the Affordable Care Act has left thousands of people in our community without access to affordable coverage. The people who find themselves in this difficult situation aren’t looking for a handout. They are working people, but because Virginia hasn’t expanded Medicaid they make too much to qualify for the existing Medicaid program and too little to qualify for subsidies through the new federal exchange.
This coverage gap is not only a source of hardship for our uninsured patients; it also puts an enormous financial strain on our hospital. The ACA eliminates $300 million a year in federal payments to Virginia hospitals to help us treat uninsured patients. Those cuts were supposed to be offset by Medicaid expansion, which would reduce the number of uninsured patients. But without Medicaid expansion or some alternative “Virginia way” of drawing down our federal tax dollars that we’ve already paid to cover the people in “the gap”, Augusta Health and hospitals around Virginia will continue to pay 100 percent of the cost to care for uninsured patients who come through our doors.
That’s a huge financial burden for our hospital, and it will force us to rethink the services we provide to all of our patients – insured or otherwise. It also drives up the cost of care for everyone.
We understand the General Assembly wants to reform Medicaid, and the Speaker has called for an in-depth audit to make the program more cost-effective. We couldn’t agree with those efforts more. We too believe in being fiscally responsible with our healthcare dollars and taxpayers’ money. That is why Augusta Health is and has been moving full steam ahead on a number of reforms that reduce Medicaid costs and provide more efficient managed care. The reforms lawmakers want to see are already underway – at our hospital and at hospitals across Virginia. But uninsured patients who could be covered with federal dollars that Virginians have already paid are at our doors right now, and we are serving them every day without the benefit of financial support. We cannot “opt-out” of our responsibility to do so.
Hospitals cannot wait two years for a legislative study on these reforms before expanding Medicaid. The damage to our financial health, the health of our community and the economy will be too great by then. There is no reason that we cannot continue to improve the system while we cover those who are now uninsured. Hospitals are treating uninsured patients right now; the financial strain is right now. We need to find a path forward this year to draw down some of the nearly $1 billion Virginia taxpayers already paid in Affordable Care Act taxes, fees and cuts. We need our legislators to understand the urgency of this issue. That message must get through. We know the Virginia General Assembly didn’t create this problem, but we are depending on them to find a solution, and we want to work with them without delay.
Mary Mannix is the president and CEO of Augusta Health in Fishersville, Va.
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