Virginia State Sen. Siobhan Dunnavant is always willing to undo regulations for big corporations, a trait that plays well among her conservative base. But her support for bills that allow insurance providers to deny health care coverage for people with pre-existing conditions might go a bit too far for the average Virginian.
More than 3.4 million Virginians live with a pre-existing condition. Dunnavant, a Republican, represents the 12th Senate district, which encompasses parts of western Henrico and Hanover Counties. There, as many as 1-in-2 non-elderly people have a pre-existing medical condition that could, under legislation Dunnavant supports, disqualify them from earning certain forms of healthcare coverage.
These short-term plans, which are supported by President Trump, would have allowed insurers to deny coverage for pre-existing conditions and enabled them to avoid providing essential health benefits, such as maternity care and prescription drug coverage.
Gov. Ralph Northam referenced these concerns when he vetoed one such bill, SB 1240, that Dunnavant voted to pass earlier this year. Northam wrote in his veto letter that the plans were “allowed to discriminate against individuals with pre-existing conditions, impose lifetime and annual caps, and are not required to provide essential health benefits.”
Critics of short-term plans also argue that they are intended to undermine the Affordable Care Act by drawing healthy people out of the more comprehensive insurance pools, which would mean higher premiums for sick people.
In another 2019 vote, Dunnavant backed SB 1027, which would have allowed for the sale of “catastrophic” health insurance plans to all individuals. Catastrophic plans have low premiums, but require individuals to meet much higher deductibles — $7,900 in 2019, according to healthcare.gov — before the plan kicks in.
Gov. Ralph Northam vetoed that bill, too, saying it would likely lead individuals enrolled in catastrophic health plans to forgo medical care because of high costs, which could cause their conditions to detioriate become more expensive to treat in the long run.
Healthcare advocates also expressed concern that the legislation would draw healthy individuals out of the traditional marketplace, which, as Northam put it, “would likely contribute to an increase in Virginia marketplace premiums across the board.”
Dunnavant’s determinance to allow some insurance plans to deny applicants based on their prior medical history is remininanscant of her far-right battle against Medicaid expansion.
A practicing OB-GYN, Dunnavant assumed office in 2016, winning her race on an aggressive anti-healthcare-expansion platform. In a 2015 campaign ad, Dunnavant lambasted supporters of Medicaid expansion in Virginia, calling them “crybaby politicians.”
While some members of Dunnavant’s party eventually joined Democrats to expand Medicaid in 2018, Dunnavant held steady in her opposition, even after conservatives succeeded in attaching work requirements as a pre-requisite to gaining coverage under the new law. Her 2018 vote against Medicaid expansion in effect signaled to the 6,600 newly eligible people in her district that she would rather they be denied access to quality, affordable health insurance, than have a lifechanging opportunity to get covered.
Today, those constituents — a plurality of which are children — are able to enroll in the expanded and booming health insurance program. Statewide, Medicaid expansion enrollments are outpacing earlier projections, with 375,000 Virginians expected to sign-up by July, 2020.
The new sign-ups will not affect the state budget because the federal government covers as much as 90 percent of the cost; revenue from a hospital tax picks up the remainder of the tab.