The under-told impact of Medicaid expansion

Last summer, I traveled to the Wise County Fairgrounds in Southwest Virginia to volunteer at the Remote Area Medical (RAM) Clinic - a sea of tents, trailers and RVs that house dentists, doctors, nurses and medical students who provide free medical, dental and vision care to rural Virginians who would otherwise go without that care.

While I always look forward to the opportunity to volunteer at RAM, I wish we didn't need one in Virginia. But every year, the volunteers keep coming back because thousands of Virginians keep lining up for care. It's a grim reminder of how many Virginians - many of them working people and their kids - continue to lack access to health insurance.

While I was there last summer, one of the clinic organizers made a point that stayed with me - at least two-thirds of the folks being treated there would have health insurance if Medicaid coverage was expanded. Thousands of men, women and children wouldn't have to wait a whole year or travel hundreds of miles to have an infected tooth pulled or get a prescription they need. They wouldn't have to wait to get a cancer diagnosis which, if caught 11 months earlier, would have been curable.

The economic arguments for Medicaid expansion are strong. Not only would it bring significant federal funds to Virginia, it would also result in state savings for high-risk pools, public employee coverage, mental health care and other services for those who are currently uninsured.

But to me, the human impact of Medicaid expansion is the under-told story, and the one worth telling louder. Outside of the rural population who would be aided, there are many other hardworking men and women across Virginia who will otherwise fall into a coverage gap. The Affordable Care Act was designed to provide subsidies and tax credits to individuals and families making between 100 and 400 percent of the federal poverty level, but without Medicaid expansion, many people below that threshold could fall into this coverage gap.

How, in the most powerful nation in the world, can this be the case? And how can RAM clinics be necessary? And why, when handed the means to insure 400,000 more people in Virginia, would we turn it down?

With a special session this week, Gov. McAuliffe and members of the General Assembly have a valuable opportunity to continue making the case for why failing to expand Medicaid is akin to withholding access to coverage from 400,000 Virginians.

If we miss this opportunity, my next trip to the RAM clinic will be the most difficult yet. How will I be able to explain that Virginia's leaders actively chose to deny these people access to care that folks facing the same economic hardship in Kentucky, West Virginia and Maryland have? The choice now lies with members of the General Assembly, and I hope they make the right one.

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