Va. hospitals pressure state lawmakers in ad campaign for ACA money

A network of Virginia hospitals on Wednesday adopted a new approach to finding a way to use federal dollars from the Affordable Care Act to relieve the economic burden on the health-care industry: Don’t call it Medicaid expansion.

Hospital chief executives gathered at an urban hospital in Richmond to unveil the Virginia Hospital & Healthcare Association’s ad campaign that will target lawmakers opposed to extending coverage to 400,000 uninsured Virginians and get residents thinking about the importance of community health care. And nowhere in the campaign will the ads mention the health-care program for the poor.

The announcement coincided with the release of census numbers that show Virginia’s neighboring states have experienced a dramatic decline in the number of uninsured residents after expanding Medicaid.

Virginia’s Republican-controlled House has fought expansion to the frustration of Gov. Terry McAuliffe (D), who made the issue the centerpiece of his first year in office.

Despite the apparent deadlock on the issue at the capitol, supporters hope the pricey campaign — with ads on TV, radio and online, as well as on buses and billboards — will ramp up the pressure on lawmakers ahead of the November election and next year’s session. “Don’t let government inaction threaten our hospitals,” one ad warns. “Government mandates and funding cuts threaten jobs, our economy and your health. Virginia hospitals: our lifeline,” a woman’s voice intones in a TV spot.

Hospitals throughout the state said they struggle with inadequate state and federal reimbursement rates and the threat of across-the-board cuts associated with sequestration.

Although many hospital officials do not expect the ACA to be repealed, they said Medicaid expansion should not be the only way to address the problem of the uninsured.

“There’s no silver bullet,” James B. Cole, president and CEO of Virginia Hospital Center in Arlington, said during a news conference. “The only way to get to something that will work in Virginia over the long term is, yes, to engage in a very serious dialogue. But even before that, . . . there is a problem and that problem is going to get worse.”

House Speaker William J. Howell (R-Stafford) has called blocking Medicaid expansion part of his legacy in the legislature, and he showed no signs of budging Wednesday. In fact, he doubled down on the idea that the ACA has been bad for hospitals.

“The speaker is happy to have a dialogue about the role hospitals play, the impact Obamacare has had on them and how the legislature can work with hospitals in the future, but Medicaid expansion is not part of that conversation,” Howell’s spokesman, Matt Moran, said in a statement.

Sen. John C. Watkins (Powhatan), one of three moderate Senate Republicans who supported an alternative to traditional expansion in 2014, said there is still a way to use federal money to buy private insurance for enrollees.

“I hope that the voters of Virginia in November will make their preferences known with regard to coming up with a solution,” he said. “I’ve always maintained that expanding government doesn’t necessarily bode well for the taxpayer, but if you’re already paying taxes to cover particular services, if there is a private sector mechanism by which that can be done, then we sure ought to be looking at it.”

Virginia is one of 21 states that have not expanded Medicaid.

States that have — including Kentucky, West Virginia and Maryland — saw dips in the number of uninsured residents from 2013 to 2014, according to a Commonwealth Institute for Fiscal Analysis look at new census data.

Michael Cassidy, president of the institute, called Virginia’s performance “dismal” because “state lawmakers have refused to be creative in reducing coverage gap.”

Arkansas, Pennsylvania and Iowa — all states with Republican governors — worked with the federal government to get permission to adjust the program, he said.

The hospital association also cited grim statistics: One-third of Virginia’s acute care hospitals operated in the red in 2013, according to Health Information data.

Billboards will be focused in a rural swath from far southwestern Virginia to Lynchburg — a region that has seen drastic cuts in health-care services in recent years and has a disproportionate share of the state’s uninsured. One hospital has closed.

The area is represented almost exclusively by Republicans opposed to expansion.

But if the view of Del. John M. O’Bannon III, a Republican neurologist from Henrico on the other side of the state, is any guide, little is likely to change.

“I welcome dialogue,” he said. “I remain convinced that not expanding Medicaid is the right way for Virginia to go.”

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