Terry McAuliffe's Health Care Plan Will Only Expand Coverage to 25,000 Uninsured Virginians

Virginia Gov. Terry McAuliffe is expected to announce his plan to expand health care for the state's poor on Monday, after failing to convince the GOP-led legislature to allow a Medicaid expansion earlier this year. The governor will announce his plan during a late morning press conference.

(Update 11:00 a.m.: McAuliffe announced a 10-step plan to expand health insurance to an estimated 25,000 uninsured Virginians — 20,000 severely mentally ill individuals and 5,000 uninsured children of low-income federal employees. The governor issued four emergency regulations and one executive order to target a small section of the uninsured, as well as address issues with drug addiction and veterans health care. The plan, "A Healthy Virginia," does not, of course, insure as many people as legislation would have.

The plan also makes modest improvements to health plans for some individuals and encourages enrolling people who already qualify for Medicaid but aren't enrolled. In total, the governor estimates it will "improve the lives" of more than 200,000 residents — though that falls short of insuring 400,000 uninsured adults. The full plan is available below.)

Expanding Medicaid was a central part of McAuliffe's campaign for governor, and a promise he's been working on since taking office in January. In March the governor and the legislature failed to reach a deal on a two-year pilot program to use federal Medicaid money to buy private insurance for low-income individuals. In May The Washington Post reported that McAuliffe was looking for ways to expand Medicaid to about 400,000 low-income Virginians, despite telling reporters that he hoped to expand health insurance through legislation. 

At the time the governor was fighting with the Virginia legislature over the state budget, and threatened to veto the bill if it didn't include Medicaid funding — the G.O.P. won, and the expansion-free budget passed in late June. That same month the governor asked his health secretary to present options for expand health care without the legislature by September 1. Earlier this year Republicans argued that there was no legal way for the governor to act unilaterally, and threatened a lawsuit if he did. Depending on today's plan, it is likely those threats will reappear. 

Here's the governor's full 10-step plan:

Step 1: Covering people with serious mental illness  

The Governor will launch the Governor’s Access Plan, or GAP, to make sure real health care reforms reach our neediest citizens.

This new and innovative plan will provide medical and behavioral health care to approximately 20,000 uninsured Virginians with severe mental illnesses.

Under Virginia Code Section 2.2-4011, Governor McAuliffe will authorize his staff to start the emergency regulation process and work with CMS on the needed waiver for this coverage. 

Step 2: Improve the coordination of care for adults and children who are already covered by Medicaid and have a serious mental illness

Governor McAuliffe is authorizing the Department of Medical Assistance Services to issue regulations to establish health homes for individuals with severe mental illness. These health homes are not physical spaces, but instead, are a model of care in which all of an individual’s primary, acute, behavioral, and long-term care services are coordinated and integrated.

By implementing this program with minimal investment, Virginia can get a 90 percent match rate of federal money. This is a fiscally responsible step that will provide 13,000 of the neediest Virginians the quality care they need.  

Steps 3 & 4: Sign up more Virginians for the Federal Marketplace, Medicaid, and FAMIS  

Unfortunately, in recent years enrollment numbers for Medicaid and FAMIS have declined and Virginia is below the national average in enrollment. Governor McAuliffe is determined to reverse that trend.

Governor McAuliffe will leverage federal and state resources to help enroll an additional 35,000 children in FAMIS and 160,000 people in the federal marketplace for health insurance.

CMS has approved the use of $4.3 million in federal health care funds to communicate with Virginians about the opportunities they have to access coverage, and on August 15th Virginia applied for an additional $10 million that will further amplify Virginia’s outreach efforts.

This outreach campaign will inform Virginians about coverage options that are already available through the federal marketplace, Medicaid and FAMIS.

Step 5: Open up FAMIS for eligible state workers to insure their children

Governor McAuliffe is directing DMAS to issue an emergency regulation making FAMIS available to the children of lower-income state workers.

By opening up this program to children of Virginia’s state workforce, Virginia can provide 5,000 children access to affordable, high-quality, and comprehensive health care. This is also a smart business practice as well since it will shift some of the costs of care from the state budget to the federal government.

Step 6: Provide dental benefits to pregnant women in Medicaid and FAMIS

Governor McAuliffe is directing DMAS to issue emergency regulations to provide comprehensive dental coverage to 45,000 pregnant women in Medicaid and FAMIS.

When a woman becomes pregnant, having access to good dental services is imperative for a healthy delivery and baby.  Adding dental coverage for pregnant women enrolled in Medicaid or FAMIS MOMS will reduce the prevalence of preterm birth, cut-down on emergency dental expenditures, and decrease the state’s cost of dental care for children. 

Step 7: Launch an innovative new website to inform Virginians of their coverage options and help them enroll

To make it easier to apply for coverage, a new and improved Cover Virginia website will be launched by this November. The Governor and his team will ensure that the Cover Virginia website is more user-friendly, has all the information our citizens need, and makes it as easy as humanly possible to apply for coverage through our existing programs.

Step 8: Accelerating access to quality health care for our veterans

A recent report showed Virginia ranked last in the nation in the number of VA hospitals and clinics available, per capita, to meet the needs of our rapidly growing veteran population.  Governor McAuliffe is committed to changing the dynamic of veteran access to health care in the Commonwealth.

Working with their counterparts in the Veterans Health Administration, Secretary of Health and Human Resources Bill Hazel and Secretary of Veterans and Defense Affairs John Harvey will lead Virginia's efforts to take full advantage of the recent legislation signed by President Obama that made $10 billion in federal money available to veterans to seek health care outside the VA system if they have barriers to access.

Step 9: Take bold actions to reduce deaths from prescription drug and heroin abuse

Last year, more Virginians died of overdose than were killed in car accidents. The prescription drug problem has reached a crisis in Virginia, where some county death rates are the highest in the entire nation.

Under Governor McAuliffe’s plan, he will act to significantly reduce the number of drug-related deaths in Virginia and will create the Task Force to Combat Prescription Drug and Heroin Abuse.

Step 10: Aggressively pursue Federal grants that can bring new dollars into Virginia for health care

Governor McAuliffe has directed his staff to pursue every federal grant currently available for health care and innovation.

Virginia, in partnership with the Virginia Center for Health Innovation, has applied for $2.6 million in federal funding through the CMS State Innovation Model grant program.  If approved, this funding will help the Commonwealth realize a broad vision for statewide health care reform that improves the health of all Virginians and will help to build a New Virginia Economy.

(Photo by Peter Courtois / Library of Virginia via the Virginia Governor's Flickr photostream)