- Associated Press - Monday, March 31, 2014

RICHMOND, Va. (AP) - Virginia’s health care advocates were busy Monday with last minute phone calls and appointments in anticipation of a midnight deadline to obtain insurance under President Barack Obama’s signature health care reform law, while a pitched partisan battle between state lawmakers over a key portion of the law continued.

Several advocates said there was a steady increase in the number of calls and requests for appointments leading up to Monday’s deadline for open enrollment for health insurance plans under the Affordable Care Act, but not an overwhelming surge.

“The phones have been lighting up,” said Jeffrey Charity, strategic project manager for the Urban League of Hampton Roads.

Others said interest was slight.

“This morning we only had a few calls,” said Honesty Liller, CEO of the McShin Foundation, a Richmond nonprofit that helps individuals with substance abuse problems. “It hasn’t been as hectic as you would think it would be.”

Under the new health care law, those who did not sign up by Monday’s deadline, or at least attempt to sign up, and don’t already have health insurance could face penalties.

Millions of people nationwide were potentially eligible for extensions, including those who began enrolling by the deadline but weren’t able to finish.

After a slow start when enrollment began in October, Virginia slightly surpassed its target total enrollment of 101,600 by the end of February. Final numbers were not immediately available, but the federal government had projected that 127,000 Virginians would sign up by the end of Monday.

Like during the October rollout, the federal government’s healthcare.gov website experienced problems Monday. The website was out of service for nearly four hours in the morning as technicians patched a software bug, and then another hiccup in early afternoon temporarily kept new applicants from signing up.

The faulty rollout of the Affordable Care Act has been a key issue in Virginia’s current debate over Medicaid expansion. The law originally envisioned large scale expansion of state Medicaid programs to cover low-income adults, but the U.S. Supreme Court ruled that states can opt out of expanding Medicaid. About half the states have opted to expand Medicaid, and Virginia is one of a handful of states actively debating the issue.

According to the Commonwealth Institute, a nonprofit that advocates for Medicaid expansion, about 195,000 Virginians fall into the so-called “coverage gap,” meaning they don’t qualify for Medicaid and have incomes too low to qualify for subsidies under the new federal insurance marketplace.

Amelia Goldsmith, a certified marketplace navigator based in Richmond said about 30 percent of people calling her seeking help signing up the new marketplace fell into the coverage gap.

New Democratic Gov. Terry McAuliffe has made expanding Medicaid his top issue, while the GOP-dominated House of Delegates firmly opposes any expansion. The impasse has threatened passage of the state’s roughly $96 billion two-year budget, which could lead to a state government shutdown if no compromise is found before July 1.

House Republicans have said that problems with other aspects of Obama’s signature health care law should make Virginia wary of signing up for Medicaid expansion, particularly the federal government’s promise of paying the bulk of expansion costs.

But McAuliffe said Medicaid expansion and problems with the federal government’s website are “apples and oranges” and predicted that Virginia wouldn’t have similar problems if it were to expand Medicaid eligibility to as many as 400,000 residents.

“We are up ready to go, and we can handle it,” McAuliffe said.

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