Making Medicaid Expansion a Reality in Virginia

It is a busy and rewarding start to the summer across the Commonwealth. A few weeks ago, the Virginia legislature voted to expand Medicaid eligibility, which means, by January 1, nearly 400,000 low-income Virginians will be able to access affordable health care coverage with a very limited, extraction-only dental benefit.

Medicaid expansion is a huge win for the overall health and well-being of all Virginia residents; thank you to Governor Northam, members of the General Assembly, and health care leaders and advocates across the state for your tireless efforts.

As the dust settles from a whirlwind May, we see a clearer picture of Medicaid expansion roll out and the next steps to make expansion a reality. The Coalition continues to focus on a smooth expansion rollout, and we will provide resources and information as they becomes available so providers, advocates, and our partner network are equipped to enroll and care for newly-eligible adults. 

Go to for comprehensive Medicaid eligibility and enrollment details, and share the Cover VA site and its resources with your partners.

Understanding the Next Steps for Medicaid Expansion

Passing legislation to expand Medicaid was only the first step for the Commonwealth; the state will submit a State Plan Amendment (SPA) to the Centers for Medicare & Medicaid Services (CMS) to inform CMS of the state’s intent to increase Medicaid eligibility under the Affordable Care Act. CMS has 90 days to respond with any questions, and Virginia has 90 days to return answers. While this process was straightforward for other Medicaid expansion states, we will pay attention to the questions CMS asks, given that Virginia is the first state to expand during the Trump administration.

At the same time, Virginia will complete a 1115 waiver application to CMS that seeks to allow Virginia to include work requirements, cost-sharing, and other changes to the Medicaid program agreed to in the expansion legislation. Because this waiver is, in essence, a negotiation with CMS, details will become clearer over time. While each state’s process is different, waiver applications typically take 18 months.  

Looking Ahead – Future Health Legislation for Virginia

As health advocates, our job is never over. Expanding Medicaid is a huge first step; however, there is more to do to ensure all Virginia residents have access to comprehensive health care. The Coalition will build on Medicaid expansion’s success by working with our partners to continue to advocate for a comprehensive dental benefit for all adults enrolled in Medicaid – this benefit will address whole-body health, improve outcomes for individuals with chronic disease, and reduce healthcare spending.

In the coming weeks, keep an eye on our website for a new webinar that dives into what Medicaid expansion means for Virginia and how you can participate in a smooth roll out. And, as we prepare for the 2019 General Assembly legislation session, we will share more information on how to advocate for a dental benefit in Medicaid and other policies that improve the health and well-being of Virginians. Sign up for our monthly Update to receive news on the Coalition’s work and learn how you can get involved to make comprehensive oral health care a reality for all Virginians. 

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Sarah Bedard Holland