It was described as something beautiful.
Critics have called it downright ugly.
At a recent meeting, Virginia health officials and lawmakers examined how the federal law known as the “One Big Beautiful Bill” could affect the commonwealth and what the state is doing to keep residents informed and covered.
鈥淭he trillion-dollar cut to the Medicaid program is the largest cut in the program’s history. In Virginia, we were initially estimating that that would be about $1.8 billion to $2.6 billion per year in terms of lost federal revenue to the state, but what we are actually finding is now that seems to be a bit of an underestimation,鈥� said Lauryn Walker, Virginia’s deputy secretary of Health and Human Resources, during a recent online panel addressing Virginia’s response to the federal healthcare changes.
鈥淎s we are looking at the new proposed rules that are coming out of the federal administration in regard to implementing H.R. 1, what we are looking at now is about a $2 to $6 billion per year in lost federal revenue,鈥� Walker said.
Walker said the changes are expected affect both urban and rural communities.
鈥淯rban areas because that鈥檚 where the volume is of our Medicaid members and our SNAP members,鈥� Walker said.
Rep. Jennifer McClellan, whose 4th Congressional District includes some rural communities, said concerns include hospitals that could be at risk of closing, including one in her district that serves patients such as struggling farmers.
While the federal law includes $189 million in Rural Transformation Health Funds for Virginia, 鈥淚t鈥檚 simply not enough to fix the damage that is caused by these cuts,鈥� McClellan said.
Changes to retroactive Medicaid eligibility that take effect in January could affect providers and patients.
Currently, retroactive payments can cover expenses incurred up to three months before enrollment. Beginning in January, that window will be reduced to one or two months.
鈥淪o, what that means is that our providers, our FQHCs [Federally Qualified Health Centers], our free clinics, but also our hospitals and our primary care clinics who are often identifying people as being eligible for Medicaid, they will not have those costs reimbursed, and we are likely to see increases in medical debt as a result, as members are not being able to have their historical medical expenses covered,鈥� Walker said.
Work requirements will also take requiring recipients to document at least 80 hours per month of work, community service, job training, enrollment in an educational program at least half time, or a combination of those activities.聽
Another change beginning in January will require some Medicaid recipients to verify their eligibility more frequently.
鈥淭hat is now going to be changing for our expansion adults, and they’re going to have to come and tell us every six months that they continue to be eligible 鈥� and so we are doing everything we can on our end to try to automate as many processes and streamline as much as we can. But that administrative burden is likely to result in significant coverage loss, and we’re just mitigating the harm at this point to try to streamline what we can,鈥� Walker said.
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