September 2014 Advocacy Update
Access to affordable health care is critical to the health and well-being of our families and community.
The Virginia General Assembly reconvened on September 18th for a special two-day session to consider the issue of Medicaid expansion. Governor McAuliffe proposed executive action to expand health care for key segments of the uninsured population earlier this month. The House of Delegates will consider a proposal by Delegate Tom Rust of Fairfax which leverages federal funds to increase enrollment in private employer-based coverage, Medicaid managed-care policies and the federal insurance exchanges. Both proposals are summarized below.
Administration’s Proposal: On September 8th, Governor Terry McAuliffe announced a 10-point plan, “A Healthy Virginia”, to improve access to healthcare in Virginia. This plan comes on the heels of several months of attempts by Governor McAuliffe to get the General Assembly on board with unilateral expansion of Medicaid to close the “coverage gap”, referring to Virginians who earn too much to qualify for Virginia’s current Medicaid program, but who don’t earn enough to qualify for subsidies under the Affordable Care Act’s health care exchanges. Despite the Governor’s efforts, he has so far been unable to convince the legislature to accept federal dollars to extend Medicaid coverage to Virginians up to 138% of the Federal Poverty Line.
Governor McAuliffe’s “A Healthy Virginia” plan works through executive action to improve access to healthcare services for some of Virginia’s most vulnerable populations who are currently without health insurance. His plan extends benefits to 20,000 mental health patients, and improves health care access for veterans, pregnant women and children of state employees. The plan also works to maximize awareness of and enrollment in existing plans such as Medicaid, FAMIS, and the Affordable Care Act’s health care exchanges.
McAuliffe’s administration suggests that the “Healthy Virginia” plan could impact up to 200,000 Virginians, including 160,000 who could be enrolled in federal health care exchanges, 20,000 mental health patients who could access insurance, broader services to nearly 45,000 pregnant women, and outreach to about 35,000 children who could be eligible for benefits through Medicaid or FAMIS, but who are not currently enrolled in a program. However, these numbers don’t come close to the estimated 400,000 Virginians who could receive coverage under a unilateral Medicaid expansion. By not accepting federal dollars for expansion, the Commonwealth is turning down nearly $2 billion per year through 2016, having forfeited $693 million to-date since deciding to not expand Medicaid on January 1st of this year.
Rust Proposal: The Virginia Health Care Independence Act leverages federal funds to increase enrollment in private employer-based coverage, Medicaid managed-care policies and the federal insurance exchanges.
The proposal involves accepting funds from the federal government into a “taxpayer recovery fund”, which will be used to provide affordable health insurance options for the low-income uninsured Virginians, up to 138% of the federal poverty line. The plan will emphasize increasing enrollment in private options by providing vouchers for the working uninsured to register for employer provided options that they previously could not afford. Additionally, the Act creates waivers and rule changes to expand health coverage, and allows individuals without access to employer-based coverage to enroll in private Medicaid managed-care plans in the short-term, before transitioning to coverage through plans on the federal health insurance exchange in the long-term.
The Virginia Health Care Independence Act is suggested to cover roughly 260,000 people, recover millions in tax dollars that Virginians have sent to Washington, and save the state about $150 million per year. Additionally, the plan is conditional on Washington’s continued financial support for the program. Should the federal government renege on their contributions, the program will end. The plan has been publicly endorsed by Governor Terry McAuliffe, and the Healthcare for All Virginians coalition.
Access to affordable health care is critical to the health and well-being of our families and community. Cornerstones supports efforts to expand coverage under Medicaid today. Please contact your legislators (particularly your representatives in the House of Delegates), and encourage them to consider the 400,000 low-income Virginians who are currently uninsured, who could access life-saving benefits under Medicaid coverage.
August 2014 Advocacy Update
Please reach out to Governor Terry McAuliffe and your state representatives to encourage them to fight for Medicaid expansion
Following the conclusion of the state budget standoff in June, public debate between the Virginia House of Delegates and Governor McAuliffe is now at a standstill, leaving much room for speculation about the future of Medicaid expansion in Virginia. Governor McAuliffe has reiterated his promise to expand Medicaid with or without the approval of the General Assembly. To that end, Secretary of Health and Human Resources, Bill Hazel, is currently tasked with assessing by what means Medicaid expansion may still be possible. Secretary Hazel’s final report is due to the Governor by September 1st.
Cornerstones continues to support the expansion of Medicaid, and will encourage our local legislators to consider the benefits of extending benefits to 400,000 Virginians who don’t yet have access to affordable health insurance. The facts are: Virginia residents have already contributed federal tax dollars for the expansion of Medicaid but have yet to receive any benefits. Failing to expand Medicaid has already lost Virginians anywhere from 600 million dollars to 1 billion dollars in federal funds. Expanding Medicaid could add up to 30,000 healthcare-related jobs, and save financially struggling hospitals. If thwarted altogether, Virginia could lose up to 2.99 billion dollars between January 2014 and June 2015.
In a July 9th press release, Speaker of the House William Howell, R-Stafford County, announced a special General Assembly meeting the week of September 22nd to discuss other ways that Medicaid could be expanded. Cornerstones will continue to track 1) efforts by the General Assembly to address Medicaid expansion and 2) efforts by Governor McAuliffe to extend coverage per Secretary Hazel’s recommendations.
In the meantime, please reach out to Governor Terry McAuliffe and your state representatives to encourage them to fight for Medicaid expansion. You can send the Governor an email through this link (https://governor.virginia.gov/constituent-services/communicating-with-the-governor/), or find your representatives here.
For questions about Medicaid extension or state budget support for housing and human service priorities, please email advocacy@cornerstonesva.org.
June 2014 Advocacy Update
Nonprofit Virginia—and other organizations across the Commonwealth—are calling on the General Assembly to honor the deal they made with passage of the 2014 budget and the bipartisan work that has been done this year in developing options to close the health care coverage gap for elderly, disabled and “the working poor” in Virginia who do not have access to health insurance or nursing home care without Medicaid.
After several months of stalemate surrounding the state budget, the General Assembly passed a budget package to accommodate the projected revenue shortfalls by reducing planned spending increases and tapping into the state’s “rainy day” fund. This budget puts the issue of expanding Medicaid aside for future discussion. The General Assembly’s approval of this budget came on the heels of the unexpected resignation of Senator Phil Puckett from southwest Virginia, a supporter of Medicaid Expansion, whose absence tipped the balance in the Senate away from support for Medicaid Expansion/Marketplace Virginia.
Nonprofit Virginia—a coalition of the leading health, housing and human services nonprofits across the state, sent a to Governor Terry McAuliffe last Thursday (6/19) urging his veto for this budget, as it fails to provide affordable health insurance to 400,000 needy Virginians, and cuts funding for mental health services and the newly established state housing trust fund, which funds development and rehabilitation of affordable housing options in the Commonwealth.
At a press conference Friday (6/20) Governor McAuliffe indicated he would have vetoed the budget if he thought the General Assembly could reach agreement before June 30, but was not willing to risk the impact on state operations and Virginia’s bond rating of a state government shutdown if no budget deal was reached in time. Instead, he decided to use his line-item veto power to remove language from the budget that requires General Assembly approval for Medicaid to be extended, and to remove any language (and therefore any decision-making power) of the Medicaid Innovation and Reform Commission (MIRC), which was set up by former Governor Bob McDonnell to initiate reforms to Medicaid as a requirement for expansion.
Governor McAuliffe indicated his intent to expand Medicaid apart from the General Assembly. Experts in Richmond speculate that the Governor will attempt to either extend the program through Executive Order, or through a Public-Private Partnership. The Governor has asked for a proposal on options to expand Medicaid from Secretary of Health and Human Services, Bill Hazel, by no later than September 1st.
The General Assembly finalized the $96 million two-year budget on Monday (6/23), after House Speaker, William J. Howell, threw out McAuliffe’s veto of the language requiring General Assembly approval for Medicaid Expansion, due to claimed “unconstitutionality” of the veto. Governor McAuliffe has restated that he intends to expand Medicaid, though it is unclear what avenue he will choose to achieve this goal. Cornerstones will continue to track this conversation throughout the summer and into the fall.
Nonprofit Virginia—and other organizations across the Commonwealth—are calling on the General Assembly to honor the deal they made with passage of the 2014 budget and the bipartisan work that has been done this year in developing options to close the health care coverage gap for elderly, disabled and “the working poor” in Virginia who do not have access to health insurance or nursing home care without Medicaid.
For questions about Medicaid extension or state budget support for housing and human service priorities, please email advocacy@cornerstonesva.org.
May 2014 Advocacy Update
Cornerstones will continue to advocate for either extension of Medicaid or Marketplace Virginia in order to provide healthcare to 400,000 low-income Virginians, 30,000 of which reside in Fairfax County.
The Fairfax County Board of Supervisors has approved its Fiscal Year 2015 budget that begins July 1, 2014, holding funding for human services level and providing increases for public safety and schools, among other County priorities. However, insufficient infrastructure and other needs will require new revenue in the future, and ideas have been put forward to look outside real estate taxes which are currently the largest source of local funding. Chairman Sharon Bulova will convene a task force to look at County needs and funding sources and Cornerstones will discuss increasing human service challenges to the safety net and the dire lack of affordable housing. More on that in our next issue!
Amidst a difficult budgeting season at both the state and local level, Cornerstones’ advocates are pleased to see the Virginia General Assembly agree on reforms to the state mental health system to strengthen the safety net, as well as allocations to the new state housing trust fund. However, final decisions on the state budget (which will have an impact on county funding) are still held up in the debate over Virginia’s extension of Medicaid coverage for low-income families, seniors and disabled persons.
To date, no compromise has been reached on the issue of Medicaid expansion. Cornerstones understands the critical need for the people it serves to have access to affordable health care, and supports expansion proposals put forth by Governor McAuliffe as well as the Senate “Marketplace Virginia” plan that is modeled after compromise efforts in other states. Marketplace Virginia would subsidize private health insurance plans for those earning 138% or less than the federal poverty level; $32,499 for a family of four or $15,856 for a single individual. These options would bring in new funding from the federal government for Virginia’s Medicaid program – which has always relied on both federal and state funding.
There are serious concerns about any proposal that ignores the health care needs of Virginia, the opportunity for a stronger federal funding base, or that diverts dollars from the Virginia General Fund (which pays for all core human services and public safety priorities) to “expand” care through payments to hospitals for emergency clinics and indigent care.
From a financial standpoint, both expansion of Medicaid and Marketplace Virginia are a good deal for the Commonwealth. Under the Affordable Care Act, states that choose to expand Medicaid are reimbursed 100% of the total cost of expansion through 2016 and no less than 90% of costs on a permanent basis. States would see only a slight increase in their costs to expand coverage and save significant costs of uncompensated care of uninsured individuals. These plans bring back between $1.7 and $2 billion per year in Virginia taxpayer dollars and are expected to save the state up to $324 million over the next two years. Allocation of federal funds to these options will also ensure that in the long term, Virginians of all income levels can regularly see health care professionals for preventative care and regular checkup visits rather than expensive care for serious (but preventable) illnesses. Currently, Virginia pays for indigent care through higher market-rate or employer-provided health insurance premiums, higher physician and hospital costs, and through state funds. Adoption of either Medicaid expansion or Marketplace Virginia would alleviate this burden from taxpayers and health care professionals. Virginia could access $5 million a day in federal funds by acting to expand health care now.
Cornerstones will continue to advocate for either extension of Medicaid or Marketplace Virginia in order to provide healthcare to 400,000 low-income Virginians, 30,000 of which reside in Fairfax County. You can aid our advocacy efforts by contacting your representative in the House of Delegates and urge them to support one of these proposals. For more information about our advocacy work, please email advocacy@cornerstonesva.org.
March 2014 Advocacy Update
You can aid our efforts by encouraging your personal legislators (especially your delegate in the House) to vote in favor of legislation that expands Medicaid, or alternatives that close the coverage gap, like Marketplace Virginia.
Virginia’s General Assembly concluded their 60-day session on Saturday, March 8th, with new legislation to address shortfalls in the state’s mental health system, and legislation to strengthen Virginia’s ethics standards. However, no budget deal was reached due to conflicting views on Medicaid Expansion, forcing the General Assembly to convene a special session beginning Monday, March 24th to make final decisions on FY15-16 funding.
Governor McAuliffe kicked off the special session with a new budget proposal, which calls for a two-year pilot program of Medicaid expansion to take advantage of the 100% federal funding coverage rate. The House of Delegates has rejected McAuliffe’s proposal, as well as the Marketplace Virginia plan proposed by the Senate in the regular session, citing their disbelief that the federal government will be able to sustain their promised 100% to 90% expansion coverage rate, and their fear that Virginia will bear a $2 billion per year bill for the new registrants if the federal government were to renege. The Senate Finance Committee has not yet voted on the Governor’s proposal.
As it currently stands, the issue of Medicaid Extension/Marketplace Virginia has not been decoupled from the rest of the budget, meaning if both the House and Senate hold their current positions, the budget will likely be a lengthy debate. This is problematic because uncertainty at the state level will make the budgeting process more difficult for localities who don’t know what to expect in funding from Richmond. There could also be interruptions in state services or a state government shutdown if the debates go longer than July 1st.
Cornerstones strongly supports Medicaid extension and has joined voices with businesses, hospitals, community organizations and non-profit partners across the state to advocate in favor of expanding. The program provides essential health insurance benefits to our low-income clients who otherwise are vulnerable to financial distress should they or any member of their family become ill. Cornerstones also supports Marketplace Virginia as a good alternative to expanding Medicaid, as it would still close the coverage gap.
You can aid our efforts by encouraging your personal legislators (especially your delegate in the House) to vote in favor of legislation that expands Medicaid, or alternatives that close the coverage gap, like Marketplace Virginia. Currently Virginia’s Medicaid program only covers children and pregnant mothers up to 133% of the federal poverty level, elderly & disabled up to 80% of the federal poverty level, and working parents up to 30% of the federal poverty level. Childless adults do not qualify. The Affordable Care Act (ACA) provides subsidies for insurance plans for individuals and families at 100% of the federal poverty level, but this leaves significant numbers of working adults, elderly, and disabled in the “coverage gap”; earning too much to qualify for Medicaid, and too little to qualify for ACA subsidies.
Extension of Medicaid would grant benefits for up to 400,000 Virginians who currently do not have health insurance, and is projected to create 30,000 jobs in Virginia over the next 6 years. Medicaid has proven rates of improving health and productivity of low-income Virginians, and has low rates of fraud (0.47% in Virginia). Virginia would also be able to include stipulations that Medicaid extensions be removed should the federal government renege on its 100%-90% match rate, as is included in the “Marketplace Virginia” plan from the Senate, and McAuliffe’s proposed budget.
In the meantime, Virginia forfeits $5 million in federal funds every day that we do not expand, and allows $2 billion of Virginia taxpayers’ money to fund expansion in other states. Please reach out to your legislators and encourage them to expand this crucial program.
February 2014 Advocacy Update
Cornerstones advocates traveled to Richmond with partners from Nonprofit Virginia and other human services organizations around the state on Wednesday, January 31st to advocate for policies that would benefit our low-income clients.
Cornerstones’ provides support and advocacy for individuals and families in need of emergency shelter, affordable housing, quality childcare and developmental supports, job training, food and financial assistance. That work includes educating the public and policy makers on needs, policies and funding to make a difference for our community.
Cornerstones advocates traveled to Richmond with partners from Nonprofit Virginia and other human services organizations around the state on Wednesday, January 31st to advocate for policies that would benefit our low-income clients. While at the General Assembly, advocates met with local legislators to ask their support for a budget that would allocate funds to the Housing Trust Fund and provide funding for the expansion of Medicaid benefits. We are tracking the progress of bills that align with these priorities.
The General Assembly budget debates are scheduled to close on Saturday, March 8th. Please join our advocacy efforts by reaching out to your legislators before then and indicate your support for:
- Allocations to the Housing Trust Fund: In his proposed budget, Former Governor Bob McDonnell allocated $4 million per year for FY2015 and FY2016 to go to the Housing Trust Fund. Since that time, Senator Colgan from Manassas has introduced a budget amendment that would increase allocations to $8 million per year. These funds would go towards loans for acquisition or rehabilitation of housing for low-income individuals and families, which are crucial to the work of Cornerstones.
- Extension of Medicaid: Currently, Virginia’s Medicaid program covers children and pregnant mothers up to 133% of the Federal Poverty Line (FPL), while only covering disabled and elderly Virginians up to 80% of the FPL and working parents up to 30% of the FPL. Childless adults are not covered under Virginia’s Medicaid program. The Affordable Care Act (ACA) will grant subsidies through the Federal Health Exchanges to anyone currently at 100% of the FPL, but this leaves many elderly, disabled, or working parents in the “Coverage Gap”; unable to obtain insurance either through Medicaid, or on the Federal Health Exchanges at a price point that they can afford. The Senate has proposed “Virginia Marketplace”, an alternative to expanding Medicaid that would use federal funds to provide private health insurance plans for Virginians up to 133% of the FPL. However, the House has not included any legislation supporting extension of either Medicaid or private subsidies in their budget. Please urge your representative in the House of Delegates to support extension of Medicaid, which would provide access to health care for many at-risk Virginians (32,000 in Fairfax County alone).
January 2014 Advocacy Update
We invite our supporters to advocate with us for budget allocations to our state Housing Trust Fund and other rapid rehousing programs.
Working in partnership with government and other nonprofit and community partners, Cornerstones connects our clients to vital resources to help them build more stable and self-sufficient lives. Advocacy is a critical part of our mission to advance policies and investments to strengthen our community and provide those vital resources.
Virginia: Eyes are on Richmond following the inauguration of Virginia’s 72nd Governor Terry McAuliffe and the convening of the 2014 Virginia General Assembly on January 8th for a 60-day work session. During this time, lawmakers will approve a two-year budget and address policy issues that impact Cornerstones’ mission including the Housing Trust Fund, Medicaid coverage, new approaches to addressing mental health needs in Virginia and other core human services programs.
During his inaugural address, Governor McAuliffe named his top priorities for his term to be expanding Medicaid, enacting new and stricter ethics rules, strengthening higher education, and diversifying Virginia’s economy, which currently is largely dependent on contracts from the federal government.
We invite our supporters to advocate with us for budget allocations to our state Housing Trust Fund and other rapid rehousing programs. Though former governor Bob McDonnell recommended $8 million go towards the Housing Trust Fund in his outgoing FY15-16 proposed budget, final decisions on the budget are still being developed in money committees in both houses of the state legislature. Please reach out to Governor Terry McAuliffe and your state representatives to encourage them to support this common sense fund . You can send the Governor an email through this link, or address mail to: 1111 East Broad Street, Richmond, VA 23219.
Cornerstones’ board members, faith communities, clients and advocates are invited to follow and connect with the coalitions and partners we work with in Richmond to address key policy issues of interest.
- Virginia Interfaith Center (www.virginiainterfaithcenter.org). The Virginia Interfaith Center for Public Policy is a statewide nonpartisan coalition of faith communities working to create progressive public policy by engaging people of faith, educating the public about social issues, the legislative process, and the call to advocacy.
- Nonprofit Virginia (www.nonprofitvirginia.org). Nonprofit Virginia provides a strong, energetic, and coordinated voice for nonprofit, community-serving organizations across the Commonwealth to meet the needs of families, children, low-income and at-risk Virginians. Cornerstones will join members of Nonprofit Virginia in Richmond on January 29, 2014 to review these critical issues.
- Voices for Virginia’s Children (www.vakids.org). Voices for Virginia’s Children is a statewide, privately funded, non-partisan policy research and advocacy organization that champions policies and practices that improve the lives of children.
- Virginia Housing Coalition (www.virginiahousingcoalition.org), Housing Opportunities Made Equal (www.phonehome.org), Virginia Coalition to End Homelessness (www.vceh.org) and Housing Virginia (www.housingvirginia.org) monitor the key policies and issues for addressing homelessness prevention and affordable housing policies and production.
- Cornerstones serves on the boards of the Dulles Regional (www.dullesregionalchamber.org) and Greater Reston Chambers of Commerce (www.restonchamber.org) and has provided input for the Chambers’ policies to support economic development through education, workforce training and job development, immigration reform, affordable and workforce housing, and the needs of low-income working families.
Fairfax County: At the local level, Cornerstones advocates have been working with other organizations in Fairfax County to promote adoption of the zoning ordinance amendment that would allow special exception development of Residential Studio Units, which are small efficiency apartments that could be ideal for single men and women who are transitioning out of homelessness as well as other individuals requiring affordable apartments, including seniors, recent graduates and those in entry-level jobs. The cost of a 1BR apartment in Fairfax County can be as much as $1400/month – out of reach for too many in our community. RSU’s provide an affordable “start-up” housing opportunity for these individuals. The Fairfax County Planning Commission has continued to accept input from the public to ensure that the goals of this program are consistent with other neighborhood zoning and affordable housing goals.
Federal: Congress avoided another federal shut-down last week with the adoption of a budget deal to guide spending, reduce the level of some automatic spending cuts under sequestration, and provide some certainty to federal employees, businesses, nonprofits and others who have been affected. While the deal does not address the decisions about long-term deficit reduction, entitlement spending or the holes in key housing and safety net programs we depend on to help our clients, the avoidance of another shutdown was critical. Cornerstones will continue to monitor the impact of the loss of housing vouchers, reduction in food stamps and other programs and bring information about how this affects families in our community.