$400 million.

That’s how much the Virginia Senate had to cut from its budget because it refused to include Medicaid expansion in the budget. The House of Delegates version of the budget has $400 million more to work with.

$400 million is a lot of money.

The change in the House of Delegates, a small miracle, comes with the change voters created last November. Republicans had a 66-34 in the House but lost 15 seats after the election.

The economic boost that comes with expanding Medicaid includes as many as 30,000 new jobs. It’s ludicrous that Virginia has bypassed this money, this economic boost, this life-saving measure for poor Virginians. The Commonwealth has forfeited than $10 billion because of ideological, partisan irrationality.

State Sen. Janet Howell may have captured the cause and effect the best in the floor debate: “We’ve cut education, both higher and public education. We’ve cut student aid, public safety, mental-health programs, programs for the disabled, programs to have a reliable election system. Why have we made these cuts? We’ve made them to deprive low-income people of healthcare.”

More than 10 percent of residents of Arlington, Alexandria and Fairfax County have no health insurance.

A Harvard Medical School study determined that the decision by 25 states to reject the expansion of Medicaid coverage under the Affordable Care Act would result in between 7,115 and 17,104 more deaths than had all states opted in.

In Virginia, the number of deaths due to failure to expand Medicaid estimated between 266 and 987.

These are wrongful deaths, caused by the willful action of particular Virginia legislators.

Refusing to accept federal funds to provide healthcare to uninsured Virginians makes no more sense than declining federal funds for transportation or education. Imagine the celebration of the economic stimulus of adding $400 million and tens of thousands of new jobs by any other means.

In Virginia, 102,000 uninsured people with a mental illness or substance use disorder could qualify for coverage if Medicaid were expanded under the Affordable Care Act.

As Virginia wrestles with heroin and opioid addiction, expanding Medicaid would allow for expanding treatment programs. One of the big obstacles to helping people who are fighting addiction is the availability of treatment when it is most needed. More people die of opioid overdoses in Virginia than in vehicle crashes.

It’s time for a change, and there is hope for change. Look towards the budget conferences coming up shortly.

— Mary Kimm

mkimm@connectionnewspapers.com