The Bulletin

Medicaid enrollment starts today with new expansion rules

By: - November 1, 2018 10:11 am
Virginia Mercury

Punctuating years of political combat, today marks the beginning of Medicaid enrollment under the new expansion rules, vastly broadening eligibility in a program that was previously one of the least generous in the country.

The new rules, passed by the General Assembly in a special session earlier this year, allows those with an annual income up to 138 percent of the federal poverty level — or $16,753 for individuals and $34,638 for a family of four — to enroll, including previously excluded single adults.

Under the state’s old rules, a disabled adult could only make $9,700 a year to qualify, while parents of young children were limited to just $6,900 a year.

Since expansion passed the General Assembly in May, the Department of Medical Assistance Services, which manages Medicaid in Virginia, has been focused on expanding coverage by January and encouraging as many of the estimated 400,000 newly-eligible Virginians to sign up as possible.

It started a website, www.coverva.org, to provide information about expansion, and new enrollees can sign up online (at CommonHelp or through healthcare.gov). They can also mail in a paper form or visit their local Department of Social Services, which has also been gearing up to enroll the newly eligible population.

But questions remain about expansion as the state barrels toward January. DMAS is due to submit a waiver to the federal government this week requesting permission to launch a new work requirement for Medicaid beneficiaries. But it could still take up to two years to launch that requirement, a timeline that has left Republicans fuming.

According to health care advocates, expansion will make a huge difference in the lives of thousands of low-income Virginians. Up to half of the expansion population is estimated to have a mental-health or substance-use diagnosis.

But barriers will remain for many. The state’s free clinics often cover people up to 200 percent of the federal poverty level or higher, and now they’re preparing for what expansion means for them as they continue to serve those who still go without insurance.

And Medicaid doesn’t cover everything. Most notably, the program lacks a dental benefit for adults, who often find themselves visiting free mobile clinics to get painful teeth extracted.

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Katie O'Connor
Katie O'Connor

Katie, a Manassas native, has covered health care, commercial real estate, law, agriculture and tourism for the Richmond Times-Dispatch, Richmond BizSense and the Northern Virginia Daily. Last year, she was named an Association of Health Care Journalists Regional Health Journalism Fellow, a program to aid journalists in making national health stories local and using data in their reporting. She is a graduate of the College of William and Mary, where she was executive editor of The Flat Hat, the college paper, and editor-in-chief of The Gallery, the college’s literary magazine.

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