Virginia's Smart Move on Health Insurance

(The Bloomberg View) -- Congratulations to the Virginia legislature for voting this week to expand the state’s Medicaid rolls. As the White House and Congress do all they can to pare health insurance coverage nationwide, Virginia’s move will push the other way, extending medical security to 400,000 more people.

In November, voters in Idaho, Nebraska and Utah, where Medicaid expansion is expected to be on the ballot, will have an opportunity to do the same — and, if they do, raise to 36 the number of states taking advantage of the Affordable Care Act’s generous Medicaid deal.

The timing is propitious because Congress’s one successful effort to undermine Obamacare is due to inflict its damage starting next year. That’s when the federal tax penalty for failing to have health insurance — the “individual mandate” — will be zeroed out, as called for in the 2017 tax bill. This change will raise the number of uninsured Americans under age 65 by 3 million, to a total of 32 million, according to the Congressional Budget Office. Over the following decade, if the mandate is not reinstated, the number could rise to 35 million.

Expanding Medicaid is one of the best ways that states can strengthen Obamacare, which extended health-care coverage to some 20 million Americans. And it’s an extraordinarily good deal: States agree to expand Medicaid to people with incomes up to 138 percent of the federal poverty level, and the federal government pays 90 percent of the bill. For Virginia, that’s about $2 billion a year. (Virginia will impose a new tax on hospitals to partly cover the balance.)

It’s not just state budgets and medical networks that benefit. When people get health insurance, they get the care they need promptly. It’s difficult to see any reason, beyond blind partisanship, that any states still resist expanding Medicaid under the ACA.

The goal of responsible health-care policy should be to see that the greatest possible number of citizens have insurance. The ultimate aim, embraced by many other rich countries, should be to protect 100 percent of the population against unaffordable health-care costs. Medicaid expansion is a big step in the right direction.

©2018 Bloomberg L.P.