RICHMOND, Va. – Virginia Governor Bob McDonnell said in his State of the Commonwealth Address this week that he will not support the Medicaid expansion in Virginia, which is part of the federal health care reform law.
The governor’s new budget reflects this decision.

Jill Hanken, an attorney with the Virginia Poverty Law Center, says the governor has stripped $1.1 billion from the budget – an amount she says is approaching what would come from the federal government to pay for Virginia's Medicaid expansion beginning January 2014.


"The federal government pays the entire cost of the expansion for the first three years, and this is bringing $2 billion a year into Virginia – which would be used not just for health services for low-income people, but it would support hospitals, businesses and overall economic activity."

According to a recent study by Chmura (Cha-MOORE-uh) Economics and Analytics in Richmond, the Medicaid expansion in Virginia would produce about 30,000 jobs, mostly in the medical field. After 2019, the state would be required to cover 10 percent of the costs for the expansion.

Hanken says the state's share is dwarfed by the amount of federal dollars that will be rolling into the state.

According to the Virginia Senate Finance Committee, the state spent more than $1 billion over the course of a 10-year period to subsidize indigent care at the University of Virginia and Commonwealth University Health Care Systems.

Hanken says federal funds for the expansion of Medicaid would offset these state costs.

"Also when hospitals do provide indigent care services, it affects all of us, our own health care insurance premiums go up by about a thousand dollars a year."

Hanken adds that Virginia has one of the most restrictive Medicaid programs in the entire country, but the expansion would alter this and about 400,000 Virginians could qualify for Medicaid health insurance.

The Virginia General Assembly will decide during its 2013 session whether to adopt the Medicaid expansion.





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More officials from South Dakota's health care community are speaking out in support of Medicaid expansion. Voters will decide this fall whether to expand Medicaid to close insurance gaps around the state.

This week, the South Dakota Emergency Medical Services Association and South Dakota Firefighters Association publicly endorsed the campaign.

Maynard Konechne, a member of the South Dakota EMS Association, said expansion would provide greater assurances first responders would be at least partially reimbursed for all their calls. He explained not having expenses covered in certain situations hurts an EMS operation's budget, including maintenance.

"You can't upgrade certain pieces of equipment, that you use daily, if they break down," Konechne pointed out. "I mean, you struggle to try and have a fundraiser and stuff."

He added volunteers for those fundraisers are getting older, and not enough people are filling their shoes.

It is estimated roughly 40,000 state residents would receive coverage if Medicaid expansion moves forward. Opponents, including Gov. Kristi Noem, cited cost concerns, but a nonpartisan state report said most expansion costs would be covered by the federal government.

Sandy Frentz, a retired public health manager for the City of Sioux Falls, applauded the new endorsements. She said the delivery of health care is a united front, and emphasized first responders are crucial in a rural state like South Dakota.

"If we lose our rural ambulance services, for example, then who takes care of that rural patient that needs to be transferred to a larger, tertiary health care system?" Frentz stressed.

Frentz, who also co-chairs the American Heart Association's South Dakota cabinet for Medicaid expansion, argued the plan can strengthen the state's economy by keeping more people in the workforce. This fall's Amendment D is supported by South Dakotans Decide Healthcare, a broad, nonpartisan coalition of organizations, including the Heart Association.

President Joe Biden will sign the CHIPS and Science Act Tuesday, a landmark measure lawmakers say could create thousands of jobs here in the Buckeye State.

Supporters of the $280 billion package say it will encourage domestic semiconductor manufacturing and strengthen supply chains. And it could mean an even bigger investment from Intel, which is already spending $20 billion on a new computer-chip facility near Columbus.

Christina Muryn, mayor of Findlay, predicts it will have a ripple effect on the entire state.

"We also have a lot of manufacturing, which requires microchips and semiconductors, with a lot of automotive suppliers nearby," Muryn pointed out. "One key area is supporting the industries that are already here and helping ensure that there's stability within their market."

The Intel facility is expected to create 20,000 jobs, and the company has hinted even greater investments are possible with passage of the CHIPS and Science Act. Despite the technology being created in the U.S., about 90% of current manufacturing is overseas. Not all Republicans voted for the bill, however, citing concerns about its focus on increasing diversity in research and STEM fields.

The legislation includes funding for training, research and workforce development. Muryn emphasized Ohio needs to ensure it creates an environment to attract young professionals interested in going into technology and manufacturing fields, and supporting educational opportunities.

"Whether that means looking at educational programs in K-12 or in higher ed, and partnering with apprenticeship programs," Muryn suggested. "Continuing to ensure that we're supporting not only front-line manufacturing but also, higher-tech positions and professional degrees is going to be really critical."

Other measures in the bill could help level the playing field by including more underrepresented groups and companies in CHIPS-funded projects, and diversifying STEM research capacity at minority-serving institutions. It will also promote clean-energy innovation in diverse geographic areas and provide block grants for economic development in underserved communities.

Support for this reporting was provided by Lumina Foundation.

Child care advocates say there is a big hole in the reconciliation package being considered by the U.S. Senate.

Support for the child care industry is not yet part of negotiations on a bill known as the Inflation Reduction Act, which does include provisions to address climate change and the cost of health care.

Gabriela Quintana, senior policy associate for the Seattle-based think tank Economic Opportunity Institute, said the industry is in dire straits.

"It's really disheartening that once again we have to beg for some attention to these really important issues that are so closely correlated to our economy and our recovery from COVID and other things going on," Quintana observed.

Earlier versions of President Joe Biden's Build Back Better framework, which has been scaled back significantly in the Inflation Reduction Act, included provisions to support families and child care workers. Washington state has lost child care providers since 2017, despite an increase in the number of children, according to Child Care Aware of Washington.

Quintana argued one area policymakers should zero in on is pay for people in the industry, who often make poverty wages.

"Given how fragile the system is, I think we really need to focus on child care teacher wages to ensure that they are sticking to the profession that they love and that they want to do," Quintana asserted. "They're just not able to earn the wages and so a lot of them are leaving the industry to go get other jobs."

Quintana noted some child care teachers leave for jobs in public school instead. The Inflation Reduction Act could get a vote as soon as this week.