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Virginia’s Medicaid program is a lifeline for 1.5 million residents, including low?wage workers, children, seniors and people with disabilities.If you’ve ever sat in a waiting room hoping your Medicaid card would cover the visit, or if you’ve helped a parent, a child, or a neighbor get to the doctor –you know how deeply this program matters. Medicaid is what keeps 1.5 million Virginians from falling through the cracks.

But the new federal budget bill –they’re calling it the “Big, Beautiful Bill” – threatens to pull the rug out. It slashes a key funding stream that helps cover Medicaid costs, pulling $2.3 billion out of Virginia’s hospitals. That could means shutting down services and even closing entire hospitals, especially in rural areas that already have fewer options.

That sounds pretty bad but it doesn’t stop there. It erects hurdles that throw working families off coverage. Starting in 2026, adults will have to prove they’re working or volunteering at least 80 hours a month just to stay insured and file the paperwork every six months. Think that’s no big deal? Over 224,700 individuals are enrolled in Medicaid in Virginia under the Aged, Blind & Disabled (ABD) eligibility category. So for our retired or disabled community, we’re forcing them back to work just to qualify for healthcare and that’s IF they can navigate the confusing bureaucracy to enroll. Miss one form, and you’re out. By some estimates, nearly 300,000 Virginians could lose their coverage this way. Co-pays of up to $35 per visit are also on the horizon. This is a huge burden for families barely scraping by.

We’re already seeing the warning signs in towns like Danville and Martinsville, where about one in three people rely on Medicaid. When hospitals shut down, it impacts everyone, including that family in a car at 2 a.m. trying to find an ER and that mom driving two hours just to deliver her baby safely. You can understand why this bill, which became law in July, 2025 has caused fear and desperation ripple throughout Virginia. And while we’re still reeling from the federal job reduction, we’re looking at even more economic ripple effects. The provider?tax reduction and work requirements could reduce hospital employment and associated jobs. The Commonwealth Fund estimates that the combined Medicaid and SNAP cuts will trigger large job losses across states, especially in health care. Rural areas with limited economic diversity will suffer the most.

Give Me Hope! 

? Start by spreading the word. Talk about it. Share this post. Make it real for the people around you.

? Then, call your state legislators and local officials. Ask them what they’re doing to protect Virginia families. Push for solutions including more state funding, simpler paperwork, expanded access. I know many of you have been religiously calling your lawmakers and it works. Especially at a local level. Congress may be able to shrug off a certain amount of calls but when your local representative gets over 10 calls from constituents, it’s a 5 alarm fire. 

? But also: let’s take care of each other. If someone in your community loses coverage, can we help them with rides to the clinic? Can we rally around a neighbor who needs a prescription filled? Can we support the local food pantry or donate to a mutual aid fund that helps cover co-pays?

This is about policy, but it’s also about people. About neighbors. About us. Let’s look to each other for solutions because when our systems start breaking down, we need to show up for each other. Let’s get to work.

For all of you stats people, I see you: 

• Statewide impact. The VHHA estimates that the new law will cost Virginia hospitals roughly US$2 billion each year, jeopardizing many facilities. The provider?tax reduction alone removes US$2.3 billion in annual Medicaid payments. Because hospitals use commercial?payer margins to subsidize Medicaid losses, further cuts could prompt service reductions or closures.

• Hospitals at risk of closure: 
  • Southampton Memorial (Franklin)
  • Southern Virginia Regional Medical Center (Emporia)
  • Community Memorial Hospital (South Hill)
  • Carilion Tazewell Community Hospital (Tazewell) 
  • Rappahannock General Hospital (Kilmarnock) 
  • Lee County Community Hospital (Pennington Gap)
• In Virginia, roughly 323,000 residents could lose health insurance through Medicaid or subsidized ACA plans. Enhanced ACA premium tax credits are also set to expire, risking another 5.1 million people nationwide.

• Expansion population most at risk. The state Department of Medical Assistance Services (DMAS) reports that around 450,000 adults are enrolled in Virginia’s Medicaid expansion, including 42,000 in Southwest Virginia. A local news report explained that Congressman Morgan Griffith’s own bill would impose similar 80?hour work requirements on this group, ostensibly to help people “get back on their feet”. Many expansion enrollees are working low?wage jobs, between jobs or caregivers, and may struggle to meet the hours or documentation requirements.

• Potential loss of coverage due to work reporting. The Commonwealth Institute projects that 187,000 Virginia adults, about 32 % of expansion enrollees, could lose coverage because of missing paperwork or not meeting the 80?hour requirement. Because the law subjects most adults to reporting regardless of whether they already work, many people could be cut off even though they hold jobs. The non?partisan Congressional Budget Office estimates that work requirements will reduce Medicaid spending by US$207 billion over ten years and leave 10 million more people uninsured.

• Cost?sharing may deter low?income families from seeking care. Copays of up to US$35 per visit could result in hundreds of dollars in out?of?pocket expenses per family each year. For families living paycheck?to?paycheck, these costs may discourage doctor visits, preventive care and prescription refills.

Sources: 

• vakids.org
• yahoo.com
• thecommonwealthinstitute.org
• wtvr.com
• cardinalnews.org
•  Virginia’s DMV data as of July 2024