The approval last week of Virginia’s expansion of Medicaid benefits to close the coverage gap for persons of low income without health insurance coverage was an historic event. After six years of opposition, the General Assembly passed the necessary authorizing legislation to allow Governor Ralph Northam to go forward with federal authorities for approval of federal health benefits for as many as 400,000 Virginians with limited income, making the Commonwealth the 33rd state to enter the program.
Approval of the program was part of a budget deal that completes the current budgetary year and authorizes funding for the entirety of state government for the next biennium. The expanded program will take effect on January 1, 2019. In addition, acceptance of the federal monies that have already been paid by Virginians through the taxes supporting the Affordable Care Act allows the new budget to free up some of the state monies that have been expended to meet the needs that will now be in the Medicaid program. About $200 million will be used to raise teacher salaries, expansion of mental health and substance-abuse services, fund almost 1,700 additional waiver slots for those with intellectual or developmental disabilities and expand preschool and programs for at-risk students.
After such an historic action, where do we go from here? Much remains to be done in changing policies in the Commonwealth which, while not necessarily budgetary, will have an important impact on our communities. Among these are responding to the threats to life and safety brought about with the excessive number of guns that are too often in the hands of violent individuals. Passing common sense measures like universal background checks would make a difference as well as simple measures that keep guns out of the hands of children. Inaction on ending gun violence is not going to be tolerated by citizens much longer.
We have been making slow progress on a variety of mental health issues, but there is much that still needs to be done. One step is to separate those who are mentally ill from those who are criminal. Mixing the two together in local jails and prisons has been a too-common occurrence that serves only one effectively. Likewise, separating juvenile misbehavior from criminal behavior is necessary to reduce the prison population and recidivism and to stop the classroom to prison pipeline.
We need to speed up our movement from the use of fossil fuels to renewable energy sources. With the abdicating of responsibility for environmental matters by the federal government, we need to have a more active state presence to ensure that our air and water are clean. Also, we need to ensure that our laws, institutional practices, and norms do not promote or allow racism, sexism or other discriminatory practices directed towards others for whatever reason. We need to make sure that elected and appointed public officials comport to the highest ethical and moral standards.
That’s the short list. Where do you think we should go in state government building on the success of Medicaid expansion? Let me know your thoughts (kenplum@aol.com); when we have clear goals and set our collective minds to the task we can get results. Expansion of Medicaid proves it!