Spanberger Orders State Agencies to Prepare for Medicaid, SNAP Changes 

Gov. Abigail Spanberger on Tuesday ordered Virginia agencies to step up efforts to prevent eligible residents from losing Medicaid and food assistance as sweeping federal changes are set to take effect next year.

The governor announced Executive Order 20 to boost the state’s implementation efforts of H.R.1, a reconciliation bill Congress passed last summer.

The move comes as the state faces approaching effective dates for changes to Medicaid access and food stamp eligibility and payment mechanisms.

Of Virginia’s nearly 2 million Medicaid enrollees, more than 500,000 will be subject to new work requirements and additional verification paperwork each year, while about 5,800 lawful immigrants will lose coverage. Roughly 749,000 Virginians receive food stamps through the Supplemental Nutrition Assistance Program to help purchase groceries.

With the eligibility requirements set to change Jan. 1, Virginia’s social services departments are working to streamline processes to keep as many eligible people as possible from losing their health insurance or benefits.

On a Zoom call with reporters Tuesday morning, Spanberger said keeping people covered is paramount to preventing healthcare cost burdens from growing further.

“We are lessening the risk that individuals may walk into a hospital with an emergency need because they haven’t previously sought medical care,” she said.

Key aspects of the order include providing “plain-language outreach” for beneficiaries subject to new eligibility requirements, strengthening collaboration between state agencies to direct certain populations to a new state-level subsidy to purchase Affordable Care Act insurance, and enhanced public-private partnerships and regional communications to help with outreach to vulnerable populations.

Dropped your ACA insurance due to spiking premiums? You could qualify for a state subsidy this fall

The order also directs state agencies to expand and improve connections to employment, volunteer, apprenticeship, job training and educational opportunities to help ensure people meet the new eligibility requirements.

To further help Virginians navigate the changes, the state also created a dashboard to track health and social services data and connect people to resources.

Health and Human Resources Secretary Marvin Figueroa said that while the state can’t promise to keep everyone covered because some people may fail to meet the new requirements, it can help reduce unnecessary coverage losses.

“Some will lose coverage because federal law changes who qualifies,” he said. “Others may still be eligible but lose coverage because a form was missed, a notice was misunderstood, or the process became too difficult to navigate. That distinction matters. A paperwork failure should not become a healthcare crisis.”

Because uninsured people are more likely to put off preventative care, eventual emergency room visits when crises arise can strain hospital budgets and lead to higher private-market insurance rates for others. Safety net providers such as free clinics and Federally Qualified Health Centers are bracing to absorb more uninsured patients, which will strain their resources as well.

Figueroa noted that the administration remains in touch with providers and regional social service workers.

Despite state budget allocations for H.R. 1 implementation, support for safety net providers and a state-level program to make up for ACA subsidies Congress allowed to expire this year, Figueroa said preparing has been tricky.

“The changes are layered, so it makes it hard to plan. Many changes come on Jan. 1, after the midterms,” he said. “But the world is not waiting for us to plan.”

Figueroa and Spanberger noted that some clinics have closed or hospitals have trimmed services in the past year, citing H.R.1 as a factor. A recent state watchdog report found that 13 rural hospitals in Virginia may be at higher risk of closure over time.

The state has also had to invest not only in implementing the federal law, but also in covering other costs the law has shifted to states.

For instance, SNAP, which was once split evenly between state and federal coffers, will move to states handling 75% of the share starting this October. H.R. 1 will also scale down what’s known as a provider tax, a funding mechanism hospitals use to support some of Virginia’s Medicaid coverage.

Spanberger noted that, on its face, H.R. 1 was intended as legislation to cut taxes because it extended a set of tax cuts from President Donald Trump’s first term, but it is made possible by sweeping changes to Medicaid and SNAP.

“Cutting a tax sounds like a good idea,” Spanberger said. But she said that the provider tax change is “pulling back dollars that had gone to hospitals” and is another way this bill is “negatively impacting the basic operations of hospitals across Virginia.”

Va. hospitals predict $31B reduction in state’s Medicaid funding if proposed CMS rule passes 

Virginia hospitals also predict billions in reductions in the state’s Medicaid funding if proposed Centers for Medicare and Medicaid Services rules stemming from H.R. 1 are adopted.

Virginia Hospital and Healthcare Association spokesman Julian Walker said in an interview last month that the proposed rules “go well beyond” what was prescribed in H.R. 1.

Despite Figueroa’s noted challenges in planning for the fallout, he emphasized that the administration would do its best to triage matters.

“What we can promise is disciplined execution. We will communicate early,” he said. “We will tell the truth of what we can and can’t do. We will publish the data, and we will listen when the process is not working and try to fix it.”

by Charlotte Rene Woods, Virginia Mercury

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