RSSOkay, so I dogged off for awhile and haven’t written anything in a while. I’ve been pretty busy with some other stuff going on and there have been a few personal challenges. Also, the fact that Christiansburg is now seen as having raised the bar for open government in the region, I found myself having to re-evaluate what I really wanted to write about.
I’ve missed a few of the C’burg Town Council meetings but since they are all recorded and online these days, it is pretty easy to keep up with things. My attention, recently, has shifted to what is happening in the General Assembly this year. So, let me jump right in to the controversy.
As of 1/3/2013 a grand total of 753 bills have been filed (with more coming in daily). 323 of those have died already as they were left in committee. The rest remain in varying degrees of health awaiting the actions of legislators.
Two of the most watched bills are likely to be the House and Senate versions of the Budget Bill. The Governor presents a budget and then the House and Senate get to modify it with their concerns addressed. Ultimately, it must end up with a package that both can accept.
The budget is one HUGE can of worms. Decisions made at the federal level concerning revenue and expenditures affect what money is available to be directed to the states. Some of that can be automatic, yet other $$$’s can be accepted or rejected by the Governor and General Assembly by decisions that they make.
When federal funds are lost, rejected, or cut, the state has less money to use at the state level and for distribution to counties, cities, and towns. Counties, cities, and towns are where the “buck passing” stops. That is where hard decisions end up being made that affect you and me. Which roads get repaired, which sections of the water system gets upgrade, how many police officers are on the road, what new equipment can be obtained by fire/rescue, what hours the library is open, what community health and mental health resources are available to those with limited income, and a whole lot more.
Many of these decisions affect those in the lowest of income levels. To gain a better understanding of how this can impact some Counties more than others, check out the data at this website: USDA ERS – County-level Data Sets: Poverty. (select State of Virginia)
There are 95 counties in the state of Virginia. In that list Montgomery County rates as the 22nd highest i poverty level. Just take a moment to look at that darned map! The pockets of poverty will show you which areas are going to be the most affected by cuts from all levels of government.
Not only do we in Montgomery County stand to lose a great deal via budget cuts, particularly where social services are concerned, but, looking at the map, those same budget cuts could be further exasperated by those neighboring areas which are likely to be hit hard as well since we count on surrounding areas to come in to shop at the Mall, buy groceries, etc.
The issue of the Expansion of Medicaid will be one of those addressed in the budget this year. The darker areas on the map will give you an idea of the areas most likely to be affected by the expansion of Medicaid. So…..
What is it about Medicaid Expansion that Could be Important to our area?
The absence of Medicaid in the budget presented by Governor McDonnell, is not necessarily the end of the road for Medicaid Expansion in Virginia. The Virginia General Assembly will now have an opportunity to make modifications to the budget, and one such modification could be putting Medicaid Expansion into it.
There are some who argue that the system must be reformed first. But, the better option might be to expand and then reform.
What are some of the key issues in this?
- Expansion of Medicaid would provide roughly 400,000 Virginians with health care. A large portion of these people are the “working poor” of Virginia. A particular note is that of those “working poor” many of them work in some of the largest employment sectors of the state: (a) tourism, (b) retail trade, (c) educational, Health, and social services, (d) Construction, (e) Professional, scientific, management, administrative, and waste management services.
- A Weldon Cooper Center Report Virginia Medicaid Now and Under Health Reform, by Dustin A. Cable, provides some interesting information: (1) Parents with young children and a family of roughly over $7,000/yr are not eligible because they make too much money. Adults, regardless of income, unless they are aged, blind, or disabled are not eligible for medicaid. *It should be noted that Virginia ranks in the top 10 states for income and in the bottom 10 states for Medicaid. In fact, Virginia’s 30% of federal poverty level income eligibility limit ranks as 44th as 43 states contribute more of their money to Medicaid. (2) Figure 3 shows how the expansion of Medicaid would impact specific counties in Virginia.
- The Federal government would cover 100% of these costs for the 1st three years and 90% of the cost after that period.
- Almost 1/2 of the 400,000 individuals who in this group are employeed in low-wage service related jobs of which we have a ton of in this area.
- Many more such issues are discussed in the articles to which links have been provided in the left-hand column.
One thing that has not been mentioned is what this expansion could possibly do for the overall health of all Virginians. Those without insurance often wait to seek treatment until they absolutely must. That means that those with infectious diseases (colds, flu, and more virulent diseases) are more likely to continue working during the early stages of an illness, finally going to a hospital when they are sickest. In the meantime, how many more people have been exposed to those diseases needlessly. Early intervention and treatment have are key components to preventing the spread of diseases.
To find out who your elected officials are and how to contact them:
- Virginia General Assembly Who’s My Legislator? Service
- Richmond Sunlight: Your Legislators
For some additional reading on the topic of Medicaid Expansion:
http://www.kff.org/medicaid/upload/8384.pdf
Governor McDonnell has not included Medicaid Expansion in Virginia.
Governor McDonnell lays out budget amendments | WTVR.com …
Health Care Reform Update — December 17, 2012 | Mintz Levin …
McDonnell: Va. won’t set up its own insurance exchange
Additional Resources on Medicaid Expansion
Hospitals caught in the Medicaid middle
Va. looks to reform Medicaid program
Medicaid Expansion in Virginia Would Improve Health and Reduce Costs
Medicaid Expansion in Virginia under the New Health Care Law
The ACA Medicaid Expansion in Virginia
Medicaid Expansion: Possible Impact on State and Local Government
The Affordable Care Act: Medicaid Expansion
Brinksmanshipon Obama Medicaid expansion for poor
A quick look at the Census Bureau will confirm some of the concern for how this area could be affected.
In the Blacksburg-Christiansburg-Radford, VA Metro Area There are a total of 74,898 in the workforce. The Median earnings for males is $31,800 and the median earnings for females is$ 22,171, with an overall median earnings of $26,990. Those working in service related industries number 14,176 and have a median earnings for males of $12,265 and females of $12,001, with an overall median earning of $12,090.
I know that there are a few people out there who will read the headline, form an opinion, and proceed to try to slap down my comments. I sincerely hope that those people will take the time to not simply argue but will share their sources of information. It is nice to have facts to look at, and who knows, maybe there enough facts to change my mind:)
