Small towns and rural communities across Virginia will lose a vital lifeline to health care if Congress follows through on its threat to pass deeply damaging, massive cuts to Medicaid. Medicaid is jointly financed by federal and state funds, and the loss of millions of dollars in federal funding would cripple Virginia’s budget and send shockwaves through our child health, maternal health, and mental health care systems.
All of us will feel the effects of funding cuts, particularly those in rural communities where children, adults (including pregnant individuals and people with disabilities), and seniors are more likely to rely on Medicaid for health insurance. A new report by the Georgetown University Center for Children and Families (CCF) illustrates the essential role Medicaid plays in Virginia’s small towns and rural communities. According to the report, Virginia is ranked 25th for the share of children covered by Medicaid/CHIP in rural communities compared to metro areas. 37.9% of children in Virginia’s rural areas and small towns receive coverage through Medicaid/FAMIS*, compared to 30.0% in urban areas.
Virginia's Top Rural Counties with Highest Percentage of Children Covered by Medicaid:
Rural communities already face unique challenges to accessing the health care they need. In Virginia, provider shortages and hospital closures mean too many people in our small towns and rural communities can’t get preventive care, see their doctor to manage chronic conditions, or get to hospital and maternity care close by. They must travel long distances to find care or forgo care altogether.
As Virginia’s Select Committee on Advancing Rural and Small Town Health Care’s Final Report highlights, 31% of counties—all of which are rural—have limited or no maternity care services, creating maternity care deserts. Medicaid coverage of Community Health Workers and Doulas, as well as parity in Medicaid reimbursements for midwives, can help bridge the gap in accessing a range of needed maternity care supports, especially in underserved areas.
In spite of states’ efforts to increase access to health care services, the loss of funding at the scale Congress is considering would force Virginia to deny coverage and services to pregnant individuals and children, amongst broader populations of adults and seniors, in order to reduce costs. And the consequences of federal Medicaid funding cuts won’t be isolated to only those who are covered by Medicaid. The impact will ripple across our health systems, hospitals, providers, and local economies. Virginia will lose funding that supports the health care needs of Virginians, including doctors and specialists across pediatric, maternal health, and mental health services.
There is simply no way for Virginia to manage its way out of these massive funding losses. Congress must say no to wide-ranging cuts to Medicaid — especially those designed to pay for tax cuts for the powerful and wealthy. What we need is all of us in Virginia working together to design approaches that balance fiscal responsibility with the health and well-being of all Virginians, and especially for the rural communities and small towns that are the backbone of our Commonwealth.
Congress must take Medicaid funding cuts off the table, and Virginia lawmakers must be prepared to stand up and fight for the health and well-being of their constituents.
* FAMIS, or Family Access to Medical Insurance Security Plan, is Virginia's Children's Health Insurance Program (CHIP)
For health equity policy priorities that Voices and our partners are championing during the 2025 legislative session, review our 2025 Legislative Agenda and follow along during session with our bill tracker.
December 18, 2024