Dr. Jennifer S. Lee, director of the Virginia Department of Medical Assistance Services. (Ned Oliver/Virginia Mercury)

More than 280,000 people have signed up for Medicaid now that Virginia has expanded the program, and the state is starting to get a clearer picture of what sort of illnesses the new enrollees are dealing with.

According to new data that Dr. Jennifer Lee, director of the state’s Medicaid program, presented to the Senate Finance Committee on Tuesday, in January and February more than 175,000 of the new members visited a provider.

During that same time period, more than 81,000 received a prescription, Lee told lawmakers.

“This is probably higher at this point in time,” she said. As of the beginning of March, about 240,000 adults had signed up for the program, according to the state’s new Medicaid expansion dashboard.

The data shows that many of the new members are dealing with complex health problems. Nearly 35,000 have a history of hypertension, more than 16,000 have a diabetes diagnosis, about 2,500 have cancer and more than 15,000 have a substance use disorder.

Lee broke that last number down further, telling the committee that around 7,000 have an opioid use disorder and more than 5,500 have an alcohol use disorder.

Additionally, more than 25,000 have a serious mental illness.

The data allows Virginia to better comprehend what needs the new enrollees have. Previously, the state had based their estimates on the experiences of other states when they expanded their programs.

Lee noted that Virginia has also been getting back surveys it sent members and providers, which show that 1 in 5 new enrollees have a mental health need.

“And the other interesting finding in the member survey is that two-thirds of them are saying they have an unmet dental care need,” she added.

Medicaid does not have a comprehensive dental benefit for adults.

Arguing over work requirement continues

During the same presentation, Lee updated the lawmakers on where the state stands with its work requirement application, which the federal government has to approve before the state can implement the changes.

Just as they did last year, Republicans lawmakers expressed dismay that penalties for failing to meet the state’s work requirements will likely not go into effect until 2021 at the earliest.

Lee explained that the delay is because the state is still working out the details of its work requirement program with the federal government. Once its application is approved, Virginia will go live with its requirements for the first year, then in the second year it will institute the penalties for those who do not comply.

Medicaid beneficiaries will risk losing coverage if they do not meet the work requirements or properly document that they qualify for one of the exemptions.

Sen. Stephen Newman, R-Lynchburg, told Lee that the timeline she described “just isn’t what we were promised.

“From the moment we came into the Senate Finance meetings, it just feels like it is delay, delay, delay,” he said.

Sen. Janet Howell, D-Fairfax, came to the state’s defense, pointing out that the source of any delay rests with the federal government.

“I don’t see any delay on the part of Virginia at all,” she said. “What I do see is the expansion population is a relatively unhealthy one. And as we bring them back to health, they will want to work, and I think that’s a fundamental difference, frankly, between Democrats and Republicans: We think people want to work. You think they want to be lazy.”

Newman countered that the plan to delay work requirements’ implementation by over two years was not discussed on the floor when lawmakers were arguing over whether or not to expand Medicaid. Work requirements made expansion more palatable to the state’s Republicans.

“I think it’s clear up here that opinions haven’t changed,” said Sen. Emmett Hanger, R-Augusta, who was a key vote in expanding Medicaid. “Those who are for it are for it, and those who are against it are against it. But we’re working through it.”