Medicaid rolls in the D.C. metro region will swell by hundreds of thousands under President Obama’s health care overhaul, hitting Virginia especially hard as the state scrambles to meet a vast new federal mandate.
The commonwealth, because its state health system is relatively modest, is expecting to take on between 275,000 and 400,000 new enrollees in the federal low-income health program after the expansion takes effect in 2014, with estimates varying depending on the predicted speed of economic recovery, said Dr. Bill Hazel, Virginia secretary of health and human resources.
The McDonnell administration believes the new Medicaid enrollment through the health bill will cost Virginia $1.14 billion in the dozen years following its implementation. That’s not including the added administrative burden to set them up in the system. Said Hazel: “Enrolling 300,000 to 400,000 people is not without cost. We’ll be investing in this along the way, and we’re trying even now to get a handle on how much it’s going to cost us.”
Even without the health bill, officials are already warning of an approaching crisis in Medicaid costs as stimulus money dries up and high jobless rates fuel demand for government help.
“This is a big challenge for states,” said Michael Bird, federal affairs counsel for the National Conference of State Legislatures. “The Medicaid program has exploded with the recession. This is putting incredible pressure on state budgets.”
As one of the central provisions of the health care legislation, eligibility for Medicaid will rise to 133 percent of the federal poverty level. The federal government will bear 100 percent of the costs for the first three years — eventually decreasing to 90 percent.
“Even an additional 10 percent is a lot of money,” said Laurens Sartoris, president of the Virginia Hospital and Healthcare Association, who worries the state will look to save money by decreasing payments to health care providers.
“Today, there aren’t enough physicians to go around to [treat] everybody anyway,” he said. “That’s before you add 30 million more Americans.”
Virginia is suing to undo Obama’s health overhaul.
Across the Potomac, Maryland officials have largely embraced it.
Maryland, which maintains a much more inclusive and expensive Medicaid program than its neighbor, expects only 135,000 new Medicaid recipients through the federal legislation, according to John Colmers, secretary of the Department of Health and Mental Hygiene.
He said the state expects to save money under the changes, because federal tax dollars will pay for services now paid through state coffers.
“I think it’s fair to say there will be savings, and I think they will be substantial,” Colmers said.
Maryland, however, has also faced a huge influx of Medicaid recipients as a result of the downturn, threatening to bust the state’s budget. Colmers said the state is banking on an economic turn around to make the problem “less of an issue.”
He said, “If things don’t turn around, that’s a different matter and that’s certainly something we and every other state are going to have to confront.”
