Will A Good Deal Become A Bad Deal?

Virginia’s statewide elected leaders–Governor McDonnell, Lieutenant Governor Bolling, and Attorney General Cuccinelli–are united about many things (even though the AG sometimes doesn’t walk in lockstep with the other) and one of them seems to be this: Virginia cannot afford to accept the expansion of Medicaid

(l-r) McDonnell, Cuccinelli, Bolling

provided for in the Affordable Care and Protection Act.

Part of the problem seems to be that Governor McDonnell keeps misunderstanding the program, calling it an unfunded mandate. It is neither a mandate–the Supreme Court changed that in its recent ruling–nor unfunded. Beginning in 2014, the federal government is set to pay 100% of the cost for three fiscal years, and then gradually the rate of federal support will decline to 90%.

This is a pretty good deal for Virginia. In fact, many experts see this as a win-win: bringing adequate health care coverage to many who have none, and also bringing billions of dollars into the state.

Some experts have said that “the total number of new Medicaid enrollees in Virginia would total over 370,000 by 2019. For those with incomes below 133 percent of FPL (federal poverty level), the expansion is estimated to reduce the uninsured non-elderly adult population in Virginia by 50.6 percent.”  The fact that many of these people currently use emergency rooms for health care–a very expensive way to care for people–while many others simply do not take good care of themselves–also a very expensive proposition, not only for those who who uncared for but but also for the rest of society which reaps a larger than necessary number of under-performing workers and less-than-fully functioning members of society.

It is so easy to talk only about expenditures of money, and say, “We can’t afford it.”

But to stay focused only on the financial outlay–which of course does not even begin until 2017– denies the reality of many other costs. We really do pay a high price for inadequate health care for hundreds of thousands of Virginians (and millions of Americans). Somehow, this rarely gets included in the equation.

This is one of the limits of much thinking these days: life is really all about money. And for many, it seems to come down to “I want to keep mine, no matter what is going on with anyone else. This is not much like loving your neighbor as yourself.

Many of those who focus so much on money claim to be Chrisitians. And no doubt they are. I am sure they believe they are living the gospel. I do not doubt their sincerity or humanity.

But they are not taking Jesus very seriously. He, like the Hebrew prophets before him, thought money and wealth was highly overrated (not necessarily bad, but not of first importance). What really matters is how we treat each other. The well-being of the entire community is of vital concern (see Ezekiel 34:4-10 for a pretty clear statement).

The medically uninsured (and the immigrants–but that subject will come another day) are our society’s contemporary version of the widows and orphans and strangers that are the focus of so much biblical teaching. Care for them is the biblical injunction hundreds of times. And of course, we still have widows and orphans who need help (including health care).

I am very concerned that Virginia will decide to forego this program–and leave hundreds of thousands of our fellow citizens effectively on the margins of our health care system. That’s a bad deal for all of us–financially, morally, socially, religiously.

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