Virginia’s General Assembly has refused to accept one of the key provisions of the Affordable Care Act, expansion of Medicaid at almost no cost to Virginia that could have covered 400,000 uninsured Virginians and would have brought more than $10 billion into the state. It has also cost lives.

Ironically, the failed bill to “repeal and replace” the Affordable Care Act included changes to Medicaid that would have penalized states, like Virginia, that did not expand Medicaid, permanently reducing federal funding.

On Monday, Gov. Terry McAuliffe proposed a budget amendment restoring his authority to pursue planning for Medicaid expansion in the wake of the failed repeal effort in Congress.

Kansas and North Carolina are taking steps this week to expand Medicaid, hoping to join the 31 other states plus the District of Columbia that have already done so.

More than 140,000 residents of Fairfax County have no health insurance. More than 40,000 residents of Arlington and Alexandria have no health insurance. That's more than 12 percent of the people who live in one of the wealthiest areas in the nation.

A Harvard Medical School study determined that the decision by 25 states to reject the expansion of Medicaid coverage under the Affordable Care Act would result in between 7,115 and 17,104 more deaths than had all states opted in. In Virginia, the number of deaths due to failure to expand Medicaid: between 266 and 987.

From a practical perspective, declining federal money to provide healthcare to uninsured Virginians makes no more sense than declining federal funds for transportation or education.

In Virginia, 102,000 uninsured people with a mental illness or substance use disorder could qualify for coverage if Medicaid were expanded under the Affordable Care Act.

As Virginia and the rest of the nation wrestles with heroin and opioid addiction, expanding Medicaid would allow for expanding treatment programs. One of the big obstacles to helping people who are fighting addiction is the availability of treatment when it is most needed.

“The time has come for us to bring our taxpayer dollars back to serve the individuals who need them the most,” said McAuliffe. “With this amendment, I’m asking the General Assembly to work with me to pursue Medicaid expansion and put this funding to work for our most vulnerable Virginians.”

Primaries for candidates for the House of Delegates plus governor, lieutenant governor and attorney general are in June, with all seats on the ballot in November. An important question as voters choose: What is their position on Medicaid expansion? How did incumbents vote?

— Mary Kimm

mkimm@connectionnewspapers.com