Virginia Expands Medicaid Access to 400,000 Citizens, But What Does it Mean for Rare Patients?

After years of resistance from the previously dominant Republican party, Virginia lawmakers were successfully able to pass a measure expanding Medicaid to nearly 400,000 more Virginians, according to the Washington Post. Democrats had been pushing to expand Medicaid when Terry McAuliffe was the governor, but they did not have enough power in the legislature in order to achieve it. There is little doubt that the expansion would not have happened had the Democrats not gained a major number of seats in state legislature last November.

The Medicaid expansion initiative was a part of the Affordable Care Act. Essentially, the law left it up to the states to determine if they wanted to expand their Medicaid program or not. 32 other states have decided to expand so far. Under the current Republican dominated federal government, the future of the Affordable Care Act may hang in the balance, but that was not enough to stop the General Assembly from moving forward with the expansion.

There is little doubt that there will be some rare disease patients that will now have access to Medicaid in Virginia that previously did not. Previously, the state’s Medicaid program was far from generous. To qualify, a disabled adult could not make more than $9,700 per year, and a family of three could not make more than $6,900. Non-disabled adults without children did not qualify, regardless of how poor they were. Essentially, to qualify for Medicaid, a person had to be living in severe poverty.

With the expansion, people making no more than $16,750 per year are now eligible, and the limit for a family of three is $28,700. These new rules will allow a greater number of desperate Virginians, including rare disease patients, to gain access to the treatment that they need to survive.

A critical question for rare disease Medicaid recipients across the country is the coverage of orphan therapies under the program. In an effort to remind program directors of the importance of this coverage, the National Organization for Rare Disorders (NORD) along with 125 other rare disease patient groups, sent letters to directors all across the country in February reminding them why this is important for rare patients that use Medicaid. You can read a copy of the letter here.

Share this post

Follow us