Affordable Care Act

Virginia Receives Approval to Expand Access to Health Care through State-Based Exchange

Federal approval puts Commonwealth on path to full state exchange by 2023

RICHMOND—Governor Ralph Northam today announced that Virginia has been approved to proceed with a state-based health insurance exchange. Approval from the Centers for Medicare & Medicaid Services allows Virginia to take over some functions of its current federal exchange beginning with open enrollment this November, and puts the Commonwealth on a path to full control by 2023.

“This approval could not come at a more critical time as we continue to battle COVID-19,” said Governor Northam. “The Trump administration is doing everything possible to gut the Affordable Care Act and kick families off their health insurance, and a state-based exchange will give Virginia the autonomy we need to expand access to care and reduce premiums. As governor and as a physician, I will never stop fighting for affordable, high-quality health care.”

By establishing the Virginia Exchange, the Commonwealth can implement policies to better address costs. The state will be able to work directly with insurance companies to meet the health coverage needs of all Virginians purchasing coverage, including small employers. Virginia will also be able to provide more targeted outreach and enrollment services and extend the time Virginians have to enroll in coverage, if needed. These strategies will expand access to health care and help increase overall affordability.

Increasing access to health care has been a top priority of the Northam administration. More than 452,000 Virginians have enrolled in new health care coverage since 2018, when Governor Northam successfully fought to expand Medicaid in Virginia. The expansion of Medicaid has proven a critical lifeline for Virginians during this health pandemic, with more than 125,603 Virginians, including 41,272 children, enrolled in Medicaid since the COVID-19 state of emergency was declared in Virginia on March 12 of this year.

The letter from the Centers for Medicare & Medicaid Services is available here.

ATTORNEY GENERAL HERRING CONTINUES TO DEFEND THE AFFORDABLE CARE ACT IN COURT

RICHMOND (March 25, 2019) – Attorney General Mark R. Herring today joined a coalition of 21 attorneys general in filing an opening brief in Texas v. U.S., defending the Affordable Care Act (ACA) and the healthcare of tens of millions of Americans. Today’s brief, filed in the U.S. Court of Appeals for the Fifth Circuit, argues that every provision of the ACA remains valid. It also details the harm that declaring the ACA invalid would have on the tens of millions of people who rely on it for access to high-quality, affordable healthcare, as well as the broader damage that it would do to the nation’s healthcare system. In June, Attorney General Herring intervened to defend against the suit, leaving him and his colleagues to defend Americans’ healthcare after President Trump switched sides and joined with Republican state attorneys general in trying to strike down the law.

“This politically motivated lawsuit is dangerous, reckless and risks the health of Americans,” said Attorney General Herring. “Millions of Virginians rely on the Affordable Care Act for quality, affordable healthcare and when the Trump Administration refused to defend the ACA in court I knew I had to step in. I will continue to join my colleagues in fighting to make sure that healthcare is not ripped away from Americans.” 

The plaintiffs, two individuals and 18 States led by Texas, filed this lawsuit in February 2018, challenging one provision of the Affordable Care Act—the requirement that individuals maintain health insurance or pay a tax. Texas’ lawsuit came after Congress reduced that tax to zero dollars December 2017. Opponents of the ACA had attempted and failed to repeal the ACA over 70 times since its instatement. The plaintiffs argued that this change made the minimum coverage provision unconstitutional. They further argued that the rest of the ACA could not be “severed” from that one provision, so the entire Act must be struck down.

On December 14, 2018, Judge Reed O’Connor of the Northern District of Texas issued his decision agreeing with the plaintiffs. In response, Attorney General Herring and his colleagues filed a motion to stay the effect of that decision and to expedite resolution of this case. The District Court granted that motion on December 30, 2018. On January 3, 2019, Attorney General Herring and his colleagues continued their legal defense in the ACA and formally filed a notice of appeal, challenging the District Court’s December 14 opinion in the Fifth Circuit.

Today’s filing continues the legal defense of the ACA. In their brief, the attorneys general argue that the plaintiffs do not have standing to challenge the minimum coverage provision, because the individual plaintiffs are not injured by a provision that now offers a lawful choice between buying insurance and paying a zero-dollar tax. The attorneys general further argue that the state plaintiffs also lack standing, because there is no evidence that the amended provision will require them to spend more money. Lastly, the District Court wrongly concluded that the minimum coverage provision was unconstitutional, and even if it were there would be no legal basis for also declaring the rest of the ACA invalid—including its provisions expanding Medicaid, reforming Medicare, and providing protections to individuals with preexisting health conditions.

The brief also highlights the consequences of upholding the district court’s decision, which would wreak havoc on the entire American healthcare system and risk lives in every state. If affirmed, the district court’s decision would affect nearly every American, including:

  • 133 million Americans, including 17 million kids, with preexisting health conditions;

  • Young adults under 26 years of age, who are covered under a parent’s health plan;

  • More than 12 million Americans who received coverage through Medicaid expansion;

  • 12 million seniors who receive a Medicare benefit to afford prescription drugs; and

  • Working families who rely on tax credits and employer-sponsored plans to afford insurance.

If successful, Texas’ lawsuit would harm Virginia by:

  • Halting Medicaid expansion, which was signed into law in Virginia last year, with the goal of covering an additional 400,000 Virginians;

  • Allowing insurance companies to deny coverage to people with pre-existing conditions or charge them more;

  • Allowing insurance companies to discriminate against women by charging them higher premiums;

  • Taking away seniors’ prescription drug discounts;

  • Ending $1.15 billion in tax credits that helped 335,000 Virginians afford insurance in 2017 alone;

  • Ending the healthcare exchange where more than 410,000 Virginians purchased their healthcare in 2017;

  • Stripping funding from our nation’s public health system, including work to combat the opioid epidemic; and

  • Ending billions in federal aid for healthcare, including $458 million in FY 2019 and $1.9 billion in FY 2020.

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ATTORNEY GENERAL HERRING STEPPING IN TO DEFEND THE AFFORDABLE CARE ACT AND VIRGINIANS’ HEALTHCARE

~Since the President and Attorney General have abandoned defense of the ACA, Herring and his colleagues are stepping in to protect accessible, affordable healthcare and Virginians with preexisting conditions~

RICHMOND (June 8, 2018) – Attorney General Mark R. Herring and a coalition of 16 state attorneys general will be defending the Affordable Care Act and the American healthcare system now that President Donald Trump and Attorney General Jeff Sessions have announced they will abandon defense of the ACA in the pending lawsuit Texas v. United States.  The Texas-led lawsuit, which now has the support of the U.S. Department of Justice, would end the ACA, threatening healthcare coverage for 20 million Americans, stripping protections from those with preexisting conditions, and ending billions of dollars in funding for critical healthcare programs and services nationwide. Attorney General Herring has joined this lawsuit to protect Virginians who benefit from the ACA, including Virginians with preexisting conditions and those who would suffer reduced access and increased premiums should this lawsuit succeed.

“It cannot be overstated how reckless, cruel, and dangerous this politically motivated lawsuit is,” said Attorney General Herring. “In seeking to strike down the entire ACA, these plaintiffs are playing games with the lives and financial well-being of millions of Americans and Virginians. Unfortunately, they now have powerful allies in President Trump and Attorney General Sessions. I will do everything I can to protect the progress we have made under the Affordable Care Act, including the life-changing Medicaid expansion that Governor Northam signed into law just yesterday. I will continue to fight to make sure that politics do not stand in the way of Virginians receiving high-quality, affordable healthcare.”

As part of their defense of the ACA, Attorney General Herring and his colleagues filed a brief yesterday in opposition to the Texas lawsuit, which seeks to end the ACA based on a far-fetched legal theory that the recently passed Republican tax bill rendered the ACA unconstitutional. Instead, Attorney General Herring and his colleagues argue that the Court should reject the request to strike down the ACA because it remains lawful, constitutional, and of vital importance to the health and well-being of Americans.

Since the ACA was implemented in 2009, Virginia’s uninsured rate has dropped from 16.4% to 12.4%, and the recently enacted Medicaid expansion is expected to drive it down even further.

If successful, Texas’ lawsuit would harm Virginia by:

  • Halting Medicaid expansion, which was signed into law in Virginia just yesterday with the goal of covering an additional 400,000 Virginians;

  • Allowing insurance companies to deny coverage to people with pre-existing conditions or charge them more;

  • Allowing insurance companies to discriminate against women by charging them higher premiums;

  • Taking away seniors’ prescription drug discounts;

  • Ending $1.15 billion in tax credits that helped 335,000 Virginians afford insurance in 2017 alone;

  • Ending the healthcare exchange where more than 410,000 Virginians purchased their healthcare in 2017;

  • Stripping funding from our nation’s public health system, including work to combat the opioid epidemic; and

  • Ending billions in federal aid for healthcare, including $458 million in FY 2019 and $1.9 billion in FY 2020.

 In total, Americans living in the states that successfully intervened could lose half a trillion dollars in healthcare funding.

Attorney General Herring and his colleagues were allowed to join this case as defendants on May 16, 2018, meaning that the states can defend the ACA in place of President Trump and Attorney General Sessions, and can appeal any adverse ruling that threatens Virginians’ access to healthcare.

Joining Attorney General Herring in defending the ACA and filing the motion opposing Texas lawsuit are the Attorneys General of California, Connecticut, Delaware, Hawai’i, Illinois, Kentucky, Massachusetts, Minnesota by and through its Department of Commerce, New Jersey, New York, North Carolina, Oregon, Rhode Island, Vermont, Washington, and the District of Columbia.

Attorney General Herring previously defended the healthcare rights of Virginians by leading a multistate coalition in the Fourth Circuit and the Supreme Court of the United States in the cases of King v. Sebelius. He intervened to defend "cost sharing reduction payments" that more than 220,000 Virginians rely on to afford healthcare, and successfully sued to block President Trump’s attempts to end the no-cost contraception benefit created by the ACA.

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VIRGINIA ORGANIZING RESPONDS TO RIDICULOUS HOUSE OF DELEGATES HEALTH CARE PLAN

Richmond, Va.—Virginia Organizing State Governing Board member Denise Smith responded to the Virginia House of Delegates proposal to include funding for “healthcare safety net” programs in the state budget today:
“This ridiculous non-solution to health care is a shame and a disgrace to all Virginians. About 400,000 hard-working Virginians need health care and are already paying for it with their federal tax dollars. The House of Delegates is proposing these same people pay with their state tax dollars to fund free clinics instead. I know from experience that free clinics only cover limited circumstances, and do not always cover necessary treatments. Free clinics are great, but they are not a substitute for primary care and health insurance. Virginians need real, quality, affordable health care. Virginians need Medicaid expansion, not a Band-Aid solution to real problems.
“Does the House of Delegates think Virginians won’t recognize that they are proposing we pay twice—once at the state level and once at the federal level—and still not even cover the 400,000 Virginians that would qualify for expansion? Do they really think that throwing extra Virginian tax dollars at free clinics will solve the problem of working people not having access to affordable health insurance?
“Virginia Organizing calls on the Virginia General Assembly to reject this terrible, incomprehensive plan and expand Medicaid for the working Virginians who are doing everything right, but being let down by political posturing against Obamacare.”

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There’s still time to sign up for health insurance

Southern Virginia Regional Medical Center Can help



EMPORIA, VA - If you’re uninsured, there’s still time to sign up for health insurance on the Health Insurance Marketplace and avoid the penalty. Under the Affordable Care Act (ACA), most Americans were required to have health insurance coverage beginning in 2014.  For the first time during the 2015 tax season, Americans must prove they had qualifying health insurance, or an approved exemption, in 2014 as required by law, or face a tax penalty. 

To be compliant with the ACA in 2015, individuals must enroll in a qualified health insurance plan before the last day of the open enrollment period, February 15, 2015.  Those who fail to obtain insurance by the deadline or without an approved exemption will have a penalty applied to his/her annual taxable income for each full month without health insurance in 2015. The penalty fee is $325 per adult, $162.50 per child – up to $975/family or 2% of family income, whichever is higher. Additionally, those without insurance will also be financially responsible for all of medical costs throughout the year.

The good news is that some individuals, based on household income and number dependents,  may qualify for financial assistance from the government – or subsidies – towards the cost of the premium and other financial obligations like co-pays or deductibles.

“This is where Southern Virginia Regional Medical Center can help the uninsured in our community,” said Joe Wilkins, Interim CEO.  “With many people lacking access to a computer or just needing help to navigate through the enrollment website, our application counselors can help. We can assist individuals and their families evaluate the available health plans, and determine if they’re eligible for Medicaid or other insurance options,” he said.

In all states, Medicaid provides health coverage for some low-income people, families and children, pregnant women, the elderly, and people with disabilities. In some states, the program covers all low-income adults below a certain income level.

“Although Virginia has chosen not to expand Medicaid, there are still many individuals in our community who may qualify for Medicaid coverage,” explained Wilkins.   “We can help screen these individuals and if they qualify, we can enroll them at any time, with health coverage beginning immediately.”

2015 open enrollment runs through February 15, 2015. To make an appointment for enrollment assistance for the Health Insurance Marketplace or Medicaid, contact the enrollment counselors at SVRMC at 434-348-4406.

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There’s still time to sign up for health insurance coverage and southern virginia regional medical center can help

If you’re uninsured, there’s still time to sign up for health insurance on the Health Insurance Marketplace and avoid the penalty.

The Affordable Care Act required that most Americans obtain health insurance by 2014 or pay a tax penalty. The penalty is applied to annual taxable income for each month without health insurance after February 15, 2015, the last day to enroll.

Based on household income and dependents, health insurance coverage may be available at no cost through Medicaid. For those who do not qualify for Medicaid, coverage may be available on the Health Insurance Marketplace.

That is where Southern Virginia Regional Medical Center (SVRMC) can help!  The applications counselors at SVRMC can assist individuals and their families evaluate the available health plans and determine eligibility for Medicaid or other insurance options, as well as assist with the enrollment process

Enrollment counselors are available Monday – Friday 8:30 AM to 4:00 PM by appointment by calling 434-348-4406.  Beginning January 6th, SVRMC will hold Enrollment Fairs in the Registration Department every Tuesday from 2:00 PM – 6:30 PM throughout the open enrollment period (enrollment fairs will end on 2/10/15).  During this time enrollment counselors will be on hand to answer questions and assist with the enrollment process.  Those interested should bring proof of residency or a driver’s license, proof of income (pay stub or W2) for all family members applying, and the social security number of anyone who is applying.

For more information regarding qualifying for any type of health insurance coverage, contact Nicole Mitchell at 434-348-4406.

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SVRMC Offers Assistance with the Affordable CAre Act

There’s still time to sign up for health insurance coverage and Southern Virginia Regional Medical Center can help.

If you’re uninsured, there’s still time to sign up for health insurance on the Health Insurance Marketplace and avoid the penalty.

The Affordable Care Act requires that most Americans obtain health insurance by 2014 or pay a tax penalty. The penalty will be applied to your annual taxable income for each month you don't have health insurance after March 31, 2014, the last day to enroll.

Based on household income and dependents, you may be eligible for health insurance coverage at no cost through Medicaid. Or, you may be eligible for new health insurance on the Health Insurance Marketplace – and financial help from the government towards the cost of premiums may be available.

“This is where Southern Virginia Regional Medical Center can help the uninsured in our community,” said Eric Lachance, SVRMC’s Chief Executive Officer. “With many people lacking access to a computer or just needing help to maneuver through the enrollment website, our application counselors can help. We can assist individuals and their families evaluate the available health plans and determine if they’re eligible for Medicaid or other insurance options,” he said.  To make an appointment for sign-up help, contact Nicole Mitchell at 434-348-4406.

All health plans on the Marketplace must offer a comprehensive set of benefits, and individuals cannot be denied coverage based on a pre-existing condition. Some of the available health benefits include preventive care and wellness services, doctor visits, prescription drugs, hospital and emergency department care, lab services, pediatric services – and more.

Even though Virginia has chosen not to expand Medicaid, there are still many individuals in our community who qualify for Medicaid coverage,” explained Lachance. “We can help screen these individuals and if they qualify, we can enroll them at any time, with health coverage beginning immediately.”

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