One after another, the patients at the new Prince William County health clinic told Virginia Gov. Terry McAuliffe (D) why they need health insurance.
Unable to find full-time work since she was laid off in 2009, Catherine Brooks, 54, borrows money from an old high school friend so she can see a kidney specialist and get her teeth cleaned.
Felix Romero is the father of five children, including a baby born just 23 days ago, and he is an American citizen. But he plans to fly to his native country, El Salvador, on Tuesday, because the prostate surgery he needs is too expensive here.
Angel Rivera, 48, says that he and his wife routinely wait to seek health care until they become so sick that they end up in the emergency room.
For all of them, McAuliffe said, the prescription is clear: Medicaid expansion.
McAuliffe’s visit to Evergreen Health Center, a new branch of a non-profit clinic which opened Monday and serves both insured and uninsured patients, was one stop on a statewide tour. During the two-week break before a special session of the legislature, when the General Assembly will vote on whether to expand Medicaid, McAuliffe and state health secretary William Hazel Jr. are on the road.
In remarks at the Manassas clinic, McAuliffe emphasized the economic benefits of accepting the federal money, while the patients demonstrated the human effects.
“These 400,000 individuals [who would be covered under the expansion] are still going to show up in hospitals. Somebody’s going to have to pay. Who’s going to pay? Businesses. Business premiums are going to go up,” McAuliffe said. He also suggested that new businesses would choose to set up shop in neighboring Maryland or West Virginia, which have chosen to accept federal Medicaid expansion dollars, rather than pay higher premiums in Virginia.
He compared Medicaid to the gas taxes that Virginians pay. “It would be like saying, ‘Our roads are fine. We don’t need any roads. Send that money to California,’” McAuliffe said as an analogy. “We have to pay this [health-care] tax. Why don’t we want this money back?”
The General Assembly came to the end of its regular session without passing a budget. Passing one will involve debate on Medicaid expansion.
Republicans say that the budget and the Medicaid question should be handled separately, and some legislative bodies in Virginia localities, which want to know what funding they can expect from the state, have expressed support for that plan. Prince William's county supervisors have discussed passing a similar resolution.
"The governor's delaying the entire budget, which has significant impacts on local government," said Matthew Moran, a spokesman for House Speaker William Howell (R-Stafford), "all in order to expand Obamacare in Virginia."
Moran added, "Republicans in Virginia have always been committed to finding ways to promote quality and affordable healthcare for people who need it. We don't think Medicaid expansion is the best way to do that."
When McAuliffe met with about a dozen of the clinic’s patients, several said that they had hoped the Affordable Care Act would provide affordable insurance for them, but they learned they did not qualify for Medicaid under the current guidelines and the cost of care through the new health exchange was still too high.
Sofia Ionescu talked about her 46-year-old daughter, who suffers from multiple sclerosis and from depression brought on by her medication. Ionescu said that her daughter, Christina Klauser, lost her job and then her home, and now lives with her.
Ionescu tried to apply for Social Security Disability Insurance for Klauser, but did not have a doctor who could verify her disability. Put on long waiting lists at clinics as far as Charlottesville, Klauser grew sicker until she had to be hospitalized in early January. She was just released the day before McAuliffe’s visit, Ionescu said. Klauser stared ahead expressionlessly throughout Ionescu’s description of her struggles.
McAuliffe pointed out that the state had paid for that costly hospital stay, which might have been avoided had Klauser received Medicaid, for which a clinic worker supervising her case said she would qualify under the expanded guidelines.
“Where are we now?” Ionescu asked. “We have no money to get her insurance, no process to get her Social Security Disability. She doesn’t have one doctor to keep on going. And her condition, it’s deepening every day. It’s not something you can just take a pill and feel better.”
Felix Romero, 47, said that he has lived in the United States for 31 years. He is raising five children here, ranging in age from 23 years to 23 days. He works in construction and notes that he is an American citizen.
But for his prostate surgery, he will fly to El Salvador on Tuesday, where the procedure is much cheaper even with the $600 cost for airfare.
McAuliffe said that Medicaid expansion could have saved him the trip, which will cost him time at work and will take him away from his newborn daughter. “You would be one of the 13,000 folks in Prince William who would be covered,” McAuliffe said. “Unfortunately, you’re already paying for it. It’s just going into Washington and not taking care of you.”
Vilna Boujois also talked about someone who left the United States for medical treatment: her stepfather, a U.S. Navy veteran. He had two heart attacks, and became so severely depressed after the second that his family could hardly get him out of bed.
Eventually, he too traveled back to his native country for cheaper care. But the treatment to improve his heart condition came too late, and he died at age 53.
McAuliffe offered his condolences to Boujois and played with her one-year-old son as the event was ending. “I want you to know that we are going to fight to get this done. You have our word on that,” he said to her.