Conservative advocates funded by the billionaire industrialist brothers Charles and David Koch have launched a massive campaign pressuring states to deny health care coverage to lower income Americans through the Medicaid expansion contained in the Affordable Care Act.
The effort, orchestrated by the group Americans for Prosperity, is targeting lawmakers in Virginia tasked with deciding whether the state should accept federal dollars to provide insurance to individuals and families below 133 percent of the federal poverty line ($31,321 in income for a family of four). Volunteers with the organization are distributing flyers through door-to-door canvassing, attending committee hearings, and according to one lawmaker who has become a target of the campaign, intimidating constituents.
As many as 400,000 Virginians could qualify for coverage if the state expands the Medicaid program, but AFP is warning Virginians that the system “will cost Virginia taxpayers billions,” require “future tax hikes and budget cuts to vital services like schools, police and fire departments,” undermine the “doctor-patient relationship,” increase wait times and even endanger lives. “Medicaid patients are almost twice as likely to die during surgery than individuals with private insurance,” the group writes on its website.
Under the Affordable Care Act, the federal government will pick up 100 percent of the cost of growing the program from 2014 to 2016 and states would contribute 10 percent thereafter. Analysis from the Commonwealth Institute for Fiscal Analysis in Richmond finds that “net savings from Medicaid expansion would average about $135 million per year in the upcoming budget cycle,” since expanding Medicaid “would allow the state to use federal funds instead of state dollars for these programs that already provide care to the uninsured in Virginia.”
Seventy-six percent of Virginia doctors treat new Medicaid patients, and the “share of doctors accepting new Medicaid patients is nearly the same as the share who are accepting new patients with private insurance or Medicare,” the Institute reports. While Medicaid beneficiaries tend to be less healthy than the general uninsured population, people who do enroll in the program “are 25 percent more likely to report that their health is ‘good’ or ‘excellent.’”
The GOP’s refusal to fully implement the Affordable Care Act will leave more than half of the nation’s uninsured working poor, approximately 8 million people, without access to health insurance. The 26 GOP-controlled states not participating in the law’s Medicaid expansion are home to a disproportionate share of low-income Americans who aren’t poor enough to qualify for the existing Medicaid program and make too much to be eligible for subsidies in the ACA’s insurance marketplaces.
Americans for Prosperity has spent millions “in states around the country, including Arkansas, Florida, Ohio, Louisiana, Michigan and Pennsylvania, to run the kind of aggressive campaign that it is now waging here in Virginia, where much will depend on the governor’s race,” the New York Times notes. Democrat Terry McAuliffe favors expansion, while his Republican opponent, Ken Cuccinelli, does not. The Virginia panel weighing in on the matter will decide the question after the Nov. 5 election.