Senator Thomas K. Norment, Jr.
Senator Emmett W. Hanger, Jr.
P.O. Box 396
Richmond, Virginia 23218
Subject: Comments on the Governor’s Proposed 2018-2020 Biennial State Budget
Dear Senator Norment and Senator Hanger,
Virginians for Quality Healthcare has long opposed Medicaid Expansion under the Affordable Care Act, believing that it is wrong for Virginia. As can be seen from states that did expand Medicaid, spending on this program has grown exponentially, exceeding all estimates and busting open state budgets while adding irresponsibly to the national debt and failing to improve health outcomes for those enrolled. Congress may ﬁnally take up welfare reform in 2018, recognizing that Medicaid is unsustainable and inefﬁcient.Virginia would be wise to avoid entrapment in Medicaid Expansion, which amounts to a costly middle-class welfare program, no
longer a safety net for the most vulnerable individuals. We ﬁrmly reject its inclusion in the Governor’s proposed biennial budget,1 and we urge the General Assembly to consider other approaches that are sustainable and that also restore the autonomy of doctors, preserve the sanctity of the patient-physician relationship, and protect patient privacy, while delivering quality care at lower costs.
We and others who are working to restore health freedom have offered ideas which deserve your serious consideration. Virginia should join the growing movement in health care innovation to adopt health care models that do not involve a third party, i.e. where government-insurer control is replaced by patient-doctor autonomy.
• Physicians abhor the growth of government interference in their profession. Administrators are dramatically outnumbering physicians nowadays. Increasingly politicians and bureaucrats exert more control over doctors’ medical practice.”2
• Legislators should also swiftly repeal antiquated Certiﬁcate of Public Need (COPN) laws which artiﬁcially restrict competition and also prevent expansion of Virginia’s capacity for health services. Those who complain about lack of care in underserved areas of the state should demand repeal of COPN. It is past time for Virginia to follow the lead of other states that have repealed COPN.
•“For nearly 40 years, Virginia’s COPN laws have stiﬂed innovation, limited competition, unnecessarily raised costs, and limited access to quality healthcare.”3
•Virginia can foster market-based competition by repealing COPN laws, thereby lowering health care costs and improving access to healthcare especially in underserved areas of Virginia.
•The General Assembly should carefully study the experiences of states that chose Medicaid Expansion, and not subject Virginians to the same destiny of those states. Government estimates of virtually every aspect of the Affordable Care Act have been wildly unreliable and erroneous, especially concerning Medicaid Expansion. Enrollment and cost projections were severely underestimated, and many expansion states’ budgets are in crisis as a result. What if Virginia’s estimate of 300,000 new Medicaid enrollees turns out to be wrong by as much as 100%?
•Legislators should also examine data on health outcomes for Medicaid beneﬁciaries. “There is evidence that even uninsured patients, who have the freedom to seek care privately, have better outcomes than Medicaid patients…It is increasingly
imperative that physicians be free to treat Medicaid patients privately on a case-by-case basis, and that patients be free to pay physicians on a case-by-case basis for both primary and specialty/subspecialty care… Possessing a Medicaid card does not guarantee timely access to medical care rendered by a physician or surgeon. Many doctors do not take Medicaid or have
stopped seeing new Medicaid patients.”4
•Medicaid is the antithesis of health freedom. “According to CMS 2015 statistics, federal, state and local government sponsored “healthcare” accounts for 46% of all health care spending. …These programs are not sustainable, and they come with such a terrible price to pay: the loss of physician autonomy, efﬁciency, and innovation…Three proven solutions in operation by
[physicians] are direct primary care models, third-party-free specialty clinics, and a private cash-based surgical center. Cash, catastrophic insurance, and true charity save money for patients and the states.”5