More than 300,000 people have signed up for Medicaid under expansion

ALEXANDRIA — Of the 303,768 people who have signed up for Medicaid since Virginia expanded the program at the start of the year, nearly 230,000 have already used a health service, like visiting a doctor or filling a prescription, according to state health officials.

Virginia hit the 300,000 enrollees mark last week, and Gov. Ralph Northam announced the milestone on Wednesday at Neighborhood Health, a health center in Alexandria with 12 locations around northern Virginia.

Nearly 100,000 of those who have signed up have already received treatment for a chronic disease such as diabetes, heart disease, cancer or substance use disorder, said Dr. Jennifer Lee, Virginia’s Medicaid director. But before they were covered by Medicaid, they rarely had access to care, she said.

Nearly 80 percent of expansion adults had trouble paying medical bills in the year before they enrolled in Medicaid, Lee said. About two-thirds of them said in a survey that they often struggled to have enough money to pay for food, frequently going without needed medical care because they couldn’t afford it.

“We’re all going to have a day when we don’t feel well and we need to go see a provider,” Northam said during Wednesday’s announcement. “Nobody in Virginia — nobody really in the richest country in the world, if you think about it — should have to make a decision of whether they stay home and put food on the table or go see a provider.”

The state estimated that nearly 400,000 people would be eligible for Medicaid under the expansion rules. Lee said in an interview that this fall her department is going to start reaching out to the populations who haven’t signed up yet, particularly parents of kids enrolled in Medicaid and Spanish-speaking populations.

Dr. Basim Khan, Neighborhood Health’s executive director, said former Gov. Terry McAuliffe toured the health center five years earlier and spoke about the importance of passing Medicaid expansion. But after years of back-and-forth between Democrats and Republicans, the state didn’t pass expansion until a special session last year.

“For the last five years — and I credit Gov. McAuliffe and his staff — we worked hard, we fought every day, and just couldn’t get it done until this past year,” said Northam, who served as McAuliffe’s lieutenant governor. “It took bipartisan support.”

To clinch that bipartisan support, lawmakers agreed to institute work requirements for Medicaid members. The state is still waiting on approval from the federal government to do so, but in other states, the effort has been blocked by the courts. Earlier this week, a federal judge struck down the work requirement program in New Hampshire, following Kentucky and Arkansas.

Lee said her agency is following the court decisions closely, but pointed out that, at this point, Virginia’s work requirement program rests with the federal government as it awaits permission to implement.

A report out this week from Gatehouse News found that states that refused to expand Medicaid under the Affordable Care Act were more likely to have shuttered or struggling rural hospitals.