Williams: Virginia must find its heart in health-care debate

The candidates in Virginia's gubernatorial race keep talking about investing in education and transportation.

How about investing in the health and well-being of the state's most vulnerable residents?

Virginia ranks 48th nationally in per-capita Medicaid expenditures. Our eligibility standards are among the most stringent in the nation, providing coverage to parents whose incomes after deductions are at 30 percent or lower of the federal poverty standard -- less than $6,000 per year for a family of three. The national Medicaid eligibility limit is 65 percent of the poverty level.

Virginia is among only 10 states with more uninsured children today -- 167,000 -- than 15 years ago.

How can this be?

Forbes magazine rates us as the top state for business. We're ranked eighth nationally in per-capita income by the Bureau of Economic Analysis.

What should be an embarrassment passes for a tradition in the MICHAEL
PAUL
WILLIAMS
Old Dominion.

"I look at Virginia and see it has a long history of being very fiscally conservative," said Jill Hanken, staff attorney with the Virginia Poverty Law Center. "And it's never treated health care as a core service of government."

Fiscal conservatism is not always a virtue.

Hanken says human-services programs haven't developed here the way they have in other states.

"It's been neglected over the years," she said. "We have a lot of ground to make up. And while the debate is going on in Washington, there are a lot of steps we can take."

Healthcare for All Virginians is a diverse coalition of 60 organizations -- representing the medical field, children, retirees and the poor --that is pushing state lawmakers to address the health-care shortcomings. It wants the state to cover all uninsured children, ensure adequate payment to Medicaid providers and improve coverage for working Virginia parents.

Its members say Virginia cannot afford to wait for whatever health-care reforms will come down from Washington. Implementation of those reforms wouldn't begin for several years.

"Uninsured children shouldn't have to wait for full implementation of national health reform to get the care that they need," Hanken said.

You don't have to be poor to feel the health-care pinch in our state. Virginia workers pay the greatest share of individual premiums (24 percent) in the nation, according to a survey by the Agency for Healthcare Research and Quality.

But the working poor and their offspring are particularly at risk.

"I think a lot of it does definitely reflect our priorities and our choices we've made in public policy and legislation over the years," said Michael Cassidy, executive director of the Commonwealth Institute for Fiscal Analysis.

Over the past several decades, Virginia has become a much wealthier state with a higher level of income, he said, but "we haven't really brought along our social safety-net programs with us."

The diagnosis? We're an affluent state with impoverished values, a paucity of compassion and shortsighted vision.

The prognosis is grim unless our lawmakers develop a heart.

Contact Michael Paul Williams at (804) 649-6815 or .