Virginia sees historic Medicaid enrollment during COVID-19 pandemic

Virginia sees historic Medicaid enrollment during COVID-19 pandemic
State social services workers signed up homeless residents for Medicaid at a resource fair in Richmond in early November. (Source: Ned Oliver/ Virginia Mercury)

Virginia’s Medicaid enrollment has increased by 55,000 more people than anticipated since a March 12 declaration of emergency at the start of the COVID-19 pandemic. The rapid climb in enrollment numbers comes with questions about how the state will shoulder the costs if federal aid ends before Virginia’s economy fully recovers from the weight of the crisis.

Participation in the program typically rises during periods of recession, according to state Finance Secretary Aubrey Layne. But experts say the surge over the last three and a half months is different, driven not just by the global pandemic and accompanying economic downturn, but by the state’s recent Medicaid expansion, which allows more residents to take advantage of the medical safety net.

“It’s even more of a reason to celebrate — that we’re able to protect more people during this pandemic,” said Karen Kimsey, director of the Virginia Department of Medical Assistance Services, which administers the state’s Medicaid program. “For people to have that security in knowing that if they need care, it’s there for them.”

The current surge is even more significant compared to the last major recession in 2008. From the start of the downturn in December 2007 to its official end in June 2009, 63,735 Virginians enrolled in the program — a significant increase compared to the previous 18-month period, which saw enrollment drop by a little more than 3,000 people. 

Since the March 12 state of emergency, a total of 92,000 residents have enrolled in Medicaid, Kimsey said — the equivalent of roughly 900 new members a day. One in six Virginians now is enrolled in the program. Some of that growth was expected based on overall increases since eligibility was expanded, in January 2019, to include all adults aged 19 to 64 below a certain income bracket.

But Kimsey said Medicaid expansion likely fueled the current recession-based surge. Hundreds of thousands of Virginians have filed for unemployment since the beginning of the coronavirus pandemic. In 2008, only some of those residents would have been able to regain health insurance through the program, which was previously limited by what she described as both “categorical and financial” requirements,

“You had to meet the financing requirements,” she said — an income below 138 percent of the federal poverty line. “And at the same time, you had to meet one of the categories of eligibility, which meant you had to be a pregnant woman or you had to be a child or you had to be a senior or a person with a disability.”

Under the expansion, any Virginian with an income up to 138 percent of the federal poverty level is now eligible for Medicaid. It’s led to greater enrollment in general, Kimsey added, but even more so during the current recession as thousands are losing job-based health insurance.

The Virginia Mercury is a new, nonpartisan, nonprofit news organization covering Virginia government and policy.