Virginia taxpayer dollars not returned to them has amounted to five million dollars each day since January 1, 2014, and will continue at that rate each day that Virginia refuses to expand its Medicaid program. In addition, at least 400,000 working Virginians will continue to be uninsured.

The 2013 session of the General Assembly created the Medicaid Innovation and Reform Commission (MIRC) to consider whether reforms to Virginia's Medicaid program were sufficient to allow Virginia to proceed with some form of coverage expansion through the Affordable Care Act. MIRC members have been assured by staff that all requested reforms have been made, but the Commission members from the House of Delegates have refused to acknowledge the reforms and continue along with the Speaker of the House of Delegates to oppose expansion of Medicaid. For otherwise fiscal conservatives to turn down five million dollars of Virginia taxpayer dollars being returned to them to pay the full cost of Medicaid expansion shows the continued animosity that some Republicans have toward the Affordable Care Act that they refer to as Obamacare. To the concern that the federal government will not be able to continue funding the program into the future, Virginia could make a decision to withdraw at that time.

At the same time, the Virginia Chamber of Commerce business plan for the Commonwealth, "Blueprint for Virginia," supports the Medicaid reforms that have been made and recommends Medicaid expansion. Chamber leadership has termed Medicaid expansion to be both an economic development as well as a workforce issue. Most of Virginia's one million uninsured residents are employed. It is projected that the expansion would create an estimated 33,000 jobs and bring $21 billion dollars back to the Commonwealth.

Governor Terry McAuliffe is a staunch supporter of Medicaid expansion. As he stated to the Chamber, "Let me be clear on one point. If Medicaid expansion is not the business community's number one priority in your communication with the General Assembly, it will not happen." He calls for "coming together, putting old ideological differences aside and focusing on what makes sense from a business perspective."

The case for Medicaid expansion goes beyond the strong business case; it is also a humanitarian cause. Social justice organizations, faith communities, and individuals need also to give priority to making their views known to legislators. Give priority to writing or calling House and Senate leadership and members of the House Appropriations and Senate Finance Committees and ask them to approve the expansion of Medicaid. Contact information is available at House and Senate members.

Five million dollars a day is a lot of money. It is too much to turn down, especially when it can improve the health and well-being of Virginians. Please make sure your voice is heard on this issue.