
Speaker of the House Mike Johnson, R-La., leaves a news conference after talking with reporters about the Republican agenda, at the Capitol in Washington, Tuesday, Jan. 7, 2025. (AP Photo/J. Scott Applewhite)
By one estimate, over 600,000 people in Virginia are at risk of automatically losing their health insurance through Medicaid if federal funding drops.
Katina Moss lived for years without health insurance.
The cost was too high for Moss, a 51-year-old Richmonder who is self-employed and helps take care of her parents. Things changed after Virginia opted in 2018 to expand its Medicaid program, which allowed Moss to get health insurance and be able to go see the doctor. Fast forward to today, and Moss is worried things could change again — but this time for the worse.
US House Republicans this month discussed at a retreat cutting federal funding for Medicaid, the federal program that for decades has provided free health care to poor and disabled Americans.
Cutting Medicaid funding and taking away the health care of tens of millions of struggling Americans in the process has long been a Republican goal. Now that Republicans have control of Congress and regained the White House this fall, the threat is even more real for the nearly 2 million people in Virginia on Medicaid.
“I don’t know what I would do, to be honest with you, especially with the cost of everything,” Moss said about the possibility of losing her health insurance. “I wouldn’t be able to go to the doctor or have any sort of medical care.”

Katina Moss gets her health insurance through Medicaid. She says she’s concerned about Republican threats to cut funding for the program. “I try not to worry,” Moss said. “But I am worried.” (Photo courtesy of Katina Moss)
Making matters more urgent in Virginia is a trigger law that would take away health coverage for hundreds of thousands of people.
The provision was included in the language authorizing Virginia to expand Medicaid eligibility to adults earning up to 138% of the federal poverty limit, and says that if federal funding for the expansion drops below 90% then the state is required to disenroll and eliminate coverage for these people.
If this trigger law were to go into effect today, it would threaten the health care of more than 600,000 people in Virginia, according to The Commonwealth Institute, a Richmond-based nonpartisan research nonprofit.
“It’s a pretty big deal,” Freddy Mejia, The Commonwealth Institute’s policy director, told The Dogwood.
Mejia said beyond the immediate impact of people losing health care coverage, there would be knock-on effects like increased medical debt and impacts to hospitals’ finances.
“We know that rural hospitals in particular are really sensitive to these issues because they have such a large Medicaid base,” Mejia said. “If Medicaid expansion were to go away, we would lose a lot of those federal dollars.”
Lawmakers should remove the language that automatically disenrolls people, Mejia said. He expects proposed budget language that would do so and require instead a legislative committee to form to respond to any cuts.
“It’s really going to be imperative to legislators to get together and figure out how they will pay for this,” Mejia said.
Del. Sam Rasoul, a Democrat from Roanoke, told The Dogwood that society needs to take seriously the threats to Medicaid and do everything possible to help working class Virginians rather than enrich a few greedy people.
“We need to be doing everything that we can to continue to build on the good bipartisan work and the investments we’ve made in Medicaid in Virginia, and also be able to push back on the narrative from the new presidential administration,” Rasoul said. “(Medicaid) brings immense value to our communities, and especially to our children and elderly.”
Meanwhile, as the debate plays out at the federal level, Democratic Rep. Jennifer McClellan of Virginia’s 4th Congressional District, opposes the Republican effort to cut Medicaid funding. McClellan, who played an important role in Virginia’s Medicaid expansion as a state senator, said cuts to Medicaid pose a significant threat to pregnant and postpartum mothers given the program currently covers one in three births in Virginia.
“Their proposed cuts to Medicaid are a senseless attack on the coverage millions of Americans have under the Affordable Care Act and will compound existing disparities, especially for historically marginalized and underserved communities,” McClellan said in a statement to The Dogwood.
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