After record investments in Virginia’s behavioral health systems, advocates for the state’s disabled community are asking Congress to make sure Medicaid funds aren’t cut during upcoming budget negotiations.
“Medicaid is hugely problematic because it has a lot of fraud, waste and abuse.” House Republican Speaker Mike Johnson speaking to reporters Tuesday morning. Johnson said recent congressional hearings suggest there’s billions in wasted funds flowing into the nation’s Medicaid system.
“Those are precious taxpayer dollars,” he said. “What we’re talking about is rooting out the fraud, waste and abuse.”
But groups in Virginia who aid those with physical and developmental disabilities worry those cuts in the name of fighting fraud will instead hurt their communities.
“Nobody wants waste and fraud. The people I know who depend on Medicaid aren’t committing fraud and they’re not wasting those services,” Teri Morgan, head of the Virginia Board of People with Disabilities, told Radio IQ Tuesday. “They’re trying to live their lives.”
Morgan has seen Virginia go from facing federal lawsuits over a decade ago due to its poor treatment of the disabled to spending record funds under Governor Glenn Youngkin.
She instead pointed to Virginia’s Medicaid Fraud Control Unit, a part of the attorney general’s office which investigates Medicaid fraud. Recent reports show the state successfully enforcing Medicaid fraud claims, often against providers who lie on timesheets.
Tony Milling is with Arc of Virginia, another group that services the developmentally disabled. She said there’s some irony in trying to find waste within a community that, according to best practices, seeks as little help as possible.
“It’s intrusive if you’re there with me all the time. Whether you’re there at my job or somewhere else, so the trends are always to do the least,” Milling said. “And you start with making sure that person can be truly as independent as they can be.”
To reinforce this point Morgan, Milling and a handful of similar organizations across the Commonwealth sent a letter to Virginia’s congressional delegation asking for Medicaid funds to not be cut. With as much as $880 billion in Medicaid cuts rumored to be on the line, Morgan warned the time to act is now.
“I think there are a lot of lawmakers who might not fully appreciate the impact that would have in their districts,” she said.
Concerns about the increasing cost of Medicaid aren’t new. The federal benefit is financially complicated, usually offering $1 for every $1 Virginia spends.
Virginia’s share of federal Medicaid funding totaled $14.8 billion in 2023, 60% of all federal funding sent to the Commonwealth. About 17% of Virginians receive such benefits, with 30% of all of Virginia’s children in the program.
It got more complicated with Medicaid expansion in 2018. Hundreds of thousands of Virginians gained coverage, but it added new financial burdens on state hospitals in the form of a “provider assessment” fee that totaled over $500 million last year.
All the while healthcare costs in the Commonwealth— and across the nation— continue to balloon; the state paid over $600 million in annual adjusted funds to the federal government in the 2025 budget cycle.
The issue was on Youngkin’s radar at the start of session, but he said then it was too early to speculate on what congress would cut.
“We do have a rapid increase in Medicaid costs in Virginia and I’ve spoken to legislators on both sides to find ways [to address it],” he said in January. “We’re not going to get at it this session but finding ways that we can in fact address the rapidly rising costs in Medicaid.”
In a statement sent Tuesday, the governor said, “Virginia would need to review any federal changes for potential impact on the Medicaid program in Virginia.”
Recent reporting also suggests Medicaid cuts may not be part of the forthcoming budget resolution.
But the possibility of cuts, also floated during Trump’s first term, doesn’t help folks like Morgan.
“It’s just a really critical time with so much uncertainty what’s happening in Washington and what’s being proposed,” she said.
Notably public outcry saw first-term-Trump’s Medicaid cuts, prosed as capped block grants, never roll out.
Milling said block grants may sound efficient, but she noted there’s already gaps in coverage. Even Youngkin’s Right Help Right Now program, which included those record funds to support the Commonwealth’s most needy, has been struggling under a lack of providers and work force shortages.
“That strategy of putting a cap on an entire system is really dangerous because we have so many people still waiting [for services],” she said.
State Senator Creigh Deeds, chair of his chamber’s Health and Human Resources Committee, said he wasn’t sure what the state might do if federal funds dry up.
“Medicaid has a human face,” he told Radio IQ Tuesday, noting two million Virginians are enrolled in the benefit. “It has to be a functioning program, and it can’t be unless the federal government fulfills its obligation.”
The Charlottesville-based official pushed for language in the 2025 budget requiring a special session if Medicaid funding was impacted, but the final conference budget removed that demand.
“If [Congress] makes drastic cuts, we’ll have to come back to Richmond and deal with that,” Delegate Mark Sickles, part of the House money committee, told Radio IQ earlier this month.
Congress is expected to start the budget negotiation process later this week.
This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.
