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Medicaid Expansion in Virginia: Yes, but Reforms First

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Medicaid expansion should only take place after real reforms are made to the federal health program for the poor and uncertainties surrounding expansion are eliminated according to a new public opinion survey released last month by the Thomas Jefferson Institute for Public Policy.

The Jefferson Institute’s survey is made more valid when compared to recent results of Wall Street Journal/NBC survey that found 47% think Obamacare is a bad idea with 34% thinking it is a good idea, and fully 48% of those currently without health insurance – those who are supposed to be helped most by this national health insurance program — also think it is a bad idea! Now let’s look at the recent survey released by the Jefferson Institute.

The Jefferson Institute sponsored this opinion survey with the Liberty Foundation and is the result of 1465 telephone response surveys conducted between July 10 and July 14, and the results have a margin of error of  plus or minus 2.56%. Although focused on the six major counties which are represented by all ten members of the special Medicaid Innovation and Reform Commission (those who will approve or disapprove Medicaid expansion by year’s end), the sampling is so large that the results  likely reflect sentiments statewide according the polling company, Magellan Strategies of Colorado.   This is a well-respected polling company that is part of the polling data used by Real Clear Politics.

This survey (available on the Jefferson Institute’s website here) shows that Medicaid is liked by the people of Virginia and they support expansion but only under certain conditions. The results show that the voters of Virginia will only accept expansion of Medicaid after real reforms are implemented that curb waste, fraud and abuse.  Not just promises of reforms, but real quantifiable reforms. This reform first position is in line with the mission of the Medicaid Commission and this survey shows that the public supports this approach.

The results of this survey show many things as the available documents show.  Three of the most important survey results are these:

79.4% of Republican voters and 50.8% of Independent voters believe it is very convincing not to expand Medicaid until the waste, fraud, and abuse in the program is truly cleaned up — not promised, but actually reformed;

72% of Republican voters and 43.7% of Independent voters believe it is very convincing not to expand Medicaid because there is so much disagreement among experts on the costs of expanding the program; and

69% of Republican voters and 48.8% of Independent voters believe it is very convincing not to expand Medicaid because we can’t count on the debt-ridden federal government’s contribution to Virginia Medicaid to last forever, so in the future Virginia taxpayers could be left to foot the bill for all the new Medicaid recipients added.

Once “somewhat convincing” voters are added to the mix, supermajorities of Republicans and Independent voters oppose expansion because of the three issues mentioned above.

This survey is interesting and deserves to be carefully reviewed by the ten members of the Medicaid Commission.  It is clear that expansion would only be supported by Republicans and Independents if true reforms take place first and the uncertainties in expansion are eliminated.  Without actual reforms in place, these voters would not support expansion. Democrat voters support Medicaid expansion in overwhelming numbers.

The results of this survey are available here where three documents can be found:  the “topline results” showing the basic questions and answers; a more detailed presentation showing the questions and a breakout of voters for each of the questions asked; and a detailed “cross tabs” of the survey allowing a more in-depth analysis of the survey.

Those Commission members who have to make the decision on whether or not to expand Medicaid here in Virginia should read this survey.  They will see that reforms that are in place and working for this federal/state program are the requirement for expansion according to the voters in this state.

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