Editor, Gazette-Journal:

In Virginia, people between the ages of 19 and 64 do not qualify for Medicaid, unless they are severely disabled. In the budget adopted earlier this month, Sen. Barker reports, "we agreed to provide Medicaid coverage to such persons if they have income below 133 percent of the poverty level, subject to certain conditions regarding reform of Medicaid."

It would be good for people gaining health care coverage, enabling them to go to doctors’ offices, stay out of emergency departments, improve their health status, and increase their life expectancy. This expansion is good for Virginia businesses, for jobs, and for the Virginia economy. Virginia businesses now pay a "hidden tax" when obtaining health insurance for their employees, paying for not only the cost of care for their employees but also part of the cost of care for the uninsured. If we do not expand Medicaid while other states do such expansions, Virginia businesses will be at a competitive disadvantage with competitors not having to pay that large "hidden tax."

Expansion will create 30,000 jobs and boost the Virginia economy significantly. For 47 years, Virginia has gotten $1.70 from the federal government for each $1.70 spent on Medicaid. For the past 15 years, we have gotten about $1.70 for each $1 spent on health care for children. For the people newly covered, if we expand Medicaid now, we will get $1.70 for every $0.01 spent. That’s a one dollar, seventy cent return for every penny.

James Bunting Kenley, MD, MPH

Virginia Commissioner of Health, 1976-1986

Port Haywood, Va.