On January 15, Consumers Union Advocacy sent me an e-mail asking me to contact my Virginia legislators about the Medicaid expansion provided for in Obamacare. Virginia’s Governor Bob McDonnell has stated he will not support the extension. I sent the letters, but I did not hear from the Governor or from Senator Bill Carrico. But I did hear back from Delegate Israel O’Quinn. He is concerned about the reliability of government, which I think is odd given that he is government. For what it is, our e-mail exchange:
Sent: Tuesday, January 15, 2013 9:01 PM
To: Israel O’Quinn
Subject: Bring our health-care dollars home!

Jan 15, 2013

Delegate Israel O’Quinn
General Assembly Building, Room 818
910 Capitol Square
Richmond, VA 23219

Dear Delegate O’Quinn,

I’m worried our state will lose out on billions of dollars set aside in health reform to extend coverage to all low-income working people in our state,  leaving our health programs continuing to struggle and missing out on huge economic stimulus and job growth.

Don’t trade Virginia’s health for political advantage. The Affordable Care Act lets our state take back tax money we’ve sent to Washington to extend health coverage to our residents earning little or no income. Say “YES” to this funding, so we don’t leave billions of our tax dollars in Washington and threaten the existence of our hospitals, as they would lose money to cover uninsured patients.

Additionally, this new funding amounts to enormous economic stimulus in the state. With the Federal government fully funding the cost of new Medicaid recipients for three years and then covering 90 percent or more of the cost each year after, we can expect to see a resulting expansion of health-care jobs in the state.

In good times or bad, it is your task to do what is best for the Commonwealth. We are still a part of the United States. Please do not deny our citizens the benefits of being Americans. I live in the Southwest, and believe me, RAM Clinics do not constitute health care. We live in a real world where real people need real health care. Please do not let this opportunity pass us by because of partisan bickering.

As you make difficult decisions during the legislative session, I urge you to support an extension of Medicaid for all low-income working families and others struggling to afford health care. It’s the right thing to do for residents, and it’s the right thing for our state’s economy and hospitals.

Sincerely,

Mrs. Sarah Williams

On the 17th, Delegate O’Quinn responded:

Dear Sarah:

Thank you for your message regarding Medicaid expansion in Virginia.  I appreciate you reaching out to us.

I am particularly concerned with issues related to access to healthcare for rural Virginians.  I genuinely appreciate the job our healthcare professionals in SWVA perform, but our residents often have to travel many, many miles to access a primary care physician or a hospital.  Thus, access to healthcare is certainly one of my top priorities.

My primary concern with Medicaid expansion is three-fold.  First, I am concerned about what happens if the federal government cannot meet its obligation for the match money they have promised.  Second, I am concerned what happens if the match money runs out or is done away with and Virginia is left with the entire tab.  Finally, it is no secret that Medicaid needs to be reformed in Virginia and we need to see a serious effort to that end before any expansion can work properly.  Medicaid continues to eat up a larger portion of our budget each and every year and that is concerning to me.

That being said, I want Southwest Virginians to have the best possible healthcare and I will continue to work to that end.

I appreciate your message and thank you for sharing you views.  While this topic will not come through a committee on which I sit,  I will certainly keep your comments in mind as we proceed forward.

Kind Regards,
Delegate Israel O’Quinn
Fifth District

I appreciate the response from Delegate O’Quinn. But the expansion of Medicaid is funded by the federal government 100% for the first three years and would never cost Virginia more than 10%, with 90% funding by the federal government, so I think his concerns about cost are unfounded. And also, hey, 30,000 jobs in Virginia, money for our doctors and hospitals, and medical care for our low-income population. And I do not understand why we need to reform Medicaid and get it perfect before we can at least give people something. So I wanted to share these concerns:

Dear Delegate O’Quinn,

Thank you for the response, and I believe it is vitally important for the access to medical care in SWVA to be foremost in our minds in this matter. Like many others who have dealt with health care concerns, I know that good primary care reduces costs over the long term by preventing many critical situations from developing.

With regard to the federal government living up to its promise of funding, we all have votes. We need to vote for people in federal office who will keep the promises. We are not a poor nation, we are not broke, but we distribute our money unwisely in expenditures that could be more economically and humanely managed by reasonable discussion. The true foundation of good government is reason exercised among reasonable people who look at proofs and likely outcomes.

As this focus on what is reasonable affects Medicaid, the most needed reform to the program — getting medical care to people who do not have it — is being facilitated at this time by the federal government. We need to snap that up and run with it. What great good we could do in the field for doctors and patients, all while we work on the policy questions! It is in my mind like first putting out the fire and then getting the appraisers and electricians and architects in to see what you need to do to fix the faulty wiring. People who disagree with me on literally everything argue compellingly for accepting this money and doing the expansion, notably Arizona’s Jan Brewer in her decision to expand Medicaid in Arizona.

This is money for Virginia hospitals and doctors that will permit them to do what they are trained to do and what we know they want to do. To turn it down because of a distrust of government is unwise. We vote. We are not a despotic regime, either at the local, state, or federal levels. People voted their trust in you, and you have become the “government” because of that trust.  We do need this money and the medical care it will provide, particularly here in SWVA. Our doctors and hospitals need it. I love the doctors who do volunteer services at RAM clinics, but I don’t want to see them doing that. I want to see them able to take care of people as they should be cared for. We need better, and this federal program extends our grasp.

Thank you again for your thoughtful response. I look forward to seeing you again here in Bristol.

– Sarah

I still expect that Virginia will turn down the federal funding and continue to enjoy RAM Clinics. In Virginia, we are so tough we don’t need health care, free is too costly if it comes from President Obama, and we know that it is better to get that faulty wiring fixed before we put out the fire.