We have good news related to the 2018 General Assembly session! And the good news comes in at least three packages.

First, we had one resolution before the General Assembly, HJ 16, declaring that March 2019 and each succeeding year will be designated as Bleeding Disorders Awareness Month. Del. Dawn Adams carried the resolution for us. Dawn is a new delegate, having been elected in November 2017. She is also a nurse practitioner, and you can tell by the low number of our resolution that ours was the first piece of legislation that she carried. Dawn will be presenting us with our resolution at the annual meeting in Newport News in June. Additionally, she will serve as a panelist in our advocacy session at our meeting. On a personal level, Dawn is a colleague and friend of mine, and I’m thrilled that she gained a seat in the General Assembly!

The second package of good news is that we were among a group of stakeholders that sought the defeat of several bills that would have eroded the requirements of the Affordable Care Act regarding essential health benefits. These were primarily attempts to pass legislation permitting out-of-state plans to be offered in the Commonwealth. All of them failed. Additionally, the Governor has vetoed several “short-term” insurance bills that are less expensive to purchase but have the net effect of draining healthy people from the insurance pool and making insurance much more expensive for those with chronic and/or preexisting conditions (like inherited bleeding disorders).

And finally, the very best news of all (saving the best for last). On Wednesday, May 30, the Virginia General Assembly passed two budget bills and sent them to the Governor for his action. HB 5001 is dubbed the “caboose” bill, meaning that it amends the budget for the remainder of FY 2018 (ending June 30, 2018). HB 5001 contains provisions authorizing the Department of Medical Services (DMAS) to submit state plan amendments and waivers to implement the expansion of Medicaid using 90% federal funding and 10% state funding for the approximately 400,000 Virginians who do not qualify to purchase health care insurance on the individual marketplace and who do not have insurance through their employers. Qualified Virginians will include childless adults aged 19-65 who earn less than 138% of the federal poverty level. If all goes as anticipated, the expansion will begin January 2019.

The biennial budget bill is HB 5002, and it contains full implementation provisions for Medicaid expansion. Funding of the 10% state match will come from a tax on private hospitals called a provider assessment tax. This tax was supported by the Virginia Hospital and Healthcare Association as a means of relieving the state of the 10% financial burden of Medicaid expansion and to supply steady revenue support to the same hospitals. The budget also will increase the Medicaid reimbursement rates on the dollar to 88 cents. Currently that figure is 77 cents on the dollar, with the remainder being compensated primarily through commercial insurance payments to hospitals.

Special thanks to our community members who advocated in support of Medicaid expansion. In 2014 when we began this Medicaid expansion journey we knew that several community members would benefit from Medicaid expansion and now these individuals will be eligible for health insurance. The Medicaid expansion provision will also include work or school requirements for individuals to maintain eligibility.

VHF has worked to advocate for expansion, along with the over 100 organizations in the Healthcare for All Virginians (HAV) coalition. Many thanks to you all for your work on this at our last five Richmond Days and in between. There is still a lot of work that needs to be done to shore up expensive health care insurance payments and improve access to health care, but this budget gets us closer to access for all our community.

And thanks for all you do to advocate for our community!

If you have questions, please feel free to contact me at bowerslanier@gmail.com or 804-382-0991.

Becky Bowers-Lanier | HACA/VHF Advocacy Consultant