Dear Friend,

This week’s newsletter highlights the serious threats to Medicaid Expansion in Virginia, spotlights a few recent press conferences, and shares select community engagements from this past week. Thank you for taking the time to read this newsletter and for staying informed.

The Threats to Virginia’s Medicaid Expansion Program

These days, a lot of concerns keep me awake at night, and Congress’s proposed dramatic cuts to essential Medicaid funding is one of them. In Virginia, these federal cuts to Medicaid will significantly impact our state budget. Even more concerning are the ways in which these cuts will harm our most vulnerable individuals as well as our entire healthcare system. Congressional Republicans, marching lockstep with the Trump/Musk administration, have put hundreds of thousands of lives at risk in the Commonwealth. 

Virginia is one of 12 states whose "trigger" law for Medicaid expansion is linked to federal funding levels. Enacted in 2018, this provision stipulates that if federal funding for Medicaid expansion falls below 90% (even if it by just 1%), the program's expansion will automatically end. As a result, over 630,000 Virginians whose lives have been dramatically improved by the program’s expansion will lose coverage immediately. For the past several years, Medicaid Expansion has provided essential healthcare coverage for our seniors, individuals with disabilities, and vulnerable children.

In recent years, federal funding contributed approximately $6.2 billion to Virginia's Medicaid Expansion. This cost is one that Virginia is not prepared to take on alone in its budget. Similarly, if Congressional Republicans, led by Elon Musk and Donald Trump, were to decrease federal funding to 50%, Virginia will still face an additional $2.5 billion in annual Medicaid expenses. This abrupt financial burden will necessitate significant budgetary adjustments, potentially affecting our other public services or requiring increased state revenues.

Federal cuts to Medicaid will also impact Virginia's hospitals, most especially our rural communities. We know that Medicaid Expansion has been crucial for our underserved localities and for those hospitals that provide care to these localities. Hospitals such as Russell County Hospital in Lebanon and Twin County Regional Hospital in Galax serve a substantial number of patients who are covered by Medicaid. At Carilion Roanoke Memorial Hospital approximately 26.4% of its patients are covered by Medicaid.

If federal funding decreases and the expansion ends, our hospitals and the broader healthcare system in Virginia will face significant financial challenges. The loss of Medicaid coverage for many patients will lead to reduced reimbursement rates and increased, uncompensated care costs. This financial strain threatens to jeopardize our healthcare structures, most especially the viability of rural hospitals, leading to reductions in services or even closures. We will see a ripple effect that harms all Virginians, regardless of coverage, as our healthcare systems make difficult decisions to decrease services and reduce staff.

At the state level, we are preparing to make decisions in response to federal actions. The Speaker of the House has called together a select committee to evaluate a broad range of issues triggered by the new Musk/Trump administration. And the Chair of Senate Finance has called a special committee to evaluate our new budget through the lens of federal actions once these actions are fully in front of us.

It is clear that federal cuts to Medicaid pose a substantial risk to Virginia's fiscal stability, potentially leading to increased state expenditures and a significant restructuring of the Medicaid program. The potential loss of Medicaid Expansion funding will lead to increased financial pressures, reduced access to care for vulnerable populations, and challenges in sustaining hospital operations.

A Week of Press Conferences

Right to Contraception Tour: Charlottesville

On Tuesday, I traveled to Charlottesville to call on Governor Youngkin to sign the Virginia Right to Contraception Act that I and Delegate Cia Price patroned again this year. Delegates Katrina Callsen and Amy Laufer, Americans for Contraception, Planned Parenthood Advocates of Virginia, and healthcare professionals joined me in highlighting the critical importance of contraception access for family planning as well as for health conditions such as PCOS. After last year’s passage of the legislation, the Governor chose to gut the legislation, deleting protections for people to use IUDs, condoms, birth control pills, and emergency contraceptives. His amendments also changed the legislation into a statement of policy rather than a codification of the protections. This year, Governor Youngkin has the opportunity to send a strong message to the large, bipartisan majority of Virginians who support this legislation. He can sign the bill as-is and protect our ability to obtain contraceptives. Today is the deadline for the Governor’s actions.

The Cost of Medicaid Cuts to Virginia

Later on Tuesday afternoon, I joined Congresswoman Jennifer McClellan, Delegate Mark Sickles, and healthcare advocates for a press conference on the harmful proposals by Congressional Republicans and their unelected leader, Elon Musk, to cut government spending on Medicaid. These cuts would eliminate healthcare coverage for over 630,000 Virginians. 

Right to Contraception Tour: Richmond

Our week of press conferences ended in Richmond, and I was joined by Delegate Betsy Carr, representatives from Americans for Contraception, Birth in Color, and Planned Parenthood Advocates of Virginia; and a community storyteller. We reiterated our call to the Governor to sign the Right to Contraception Act. At the end of the press conference, we hand-delivered 55,000 petition signatures directly to the Governor. 

Anniversary of the Affordable Care Act

Sunday marked the 15th anniversary of the passage of the Affordable Care Act (ACA)—a historic piece of federal legislation that expanded health insurance coverage to millions of Americans, prevents people from being denied coverage due to preexisting conditions, eliminates patient cost sharing for high-value preventive services, and more. Forty-five million people are currently enrolled in Marketplace or Medicaid expansion coverage under provisions of the Affordable Care Act (ACA), the highest total on record. The ACA and subsequent Medicaid expansion legislation across our nation has statistically improved access to care and health outcomes within our communities, with an estimated 19,000 lives saved within just the first four years of implementation. 

The ACA and Medicaid expansion are popular, but there are efforts in Washington led by Elon Musk, Donald Trump, and Congressional Republicans to give out trillions in tax cuts to the wealthiest Americans and eliminate trillions of dollars towards federal agencies, programs, and staff—two things that cannot be accomplished without slashing vital Medicaid funding by an estimated $880 billion and critically reducing funding for our federal agencies and programs, like ACA Navigators. Health care is a human right, and it is crucial that we continue to advocate for healthcare affordability and accessibility for our communities. 

Connecting With My Office

My office can be reached at the following:

Email:  [email protected] 

Phone:  804.698.7515

If you were forwarded this email, you can sign up to receive my office’s weekly newsletter here. 

— Ghazala

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