ADRIENNE HOAR McGIBBON: The Energy and Commerce Committee, which youre a member of, was tasked with cutting $880 billion over the next 10 years from Medicaid.

What do you think that could mean for Virginians?

JENNIFER McCLELLAN: Preliminary estimates show that not only were there cuts in Medicaid, but that the bill could trigger significant cuts in Medicare, because of the Pay-As-You-Go law.

And so, I think between the gutting of the Affordable Care Act, the gutting of Medicaid, we will see hundreds of thousands of Virginians who will lose their health insurance but they'll still get sick.

And they will go to the emergency room when it's more expensive to treat, oftentimes when it's too late to treat, and those costs will be passed to the rest of us.

That's exactly why we expanded Medicaid in Virginia back in 2018 when I was in the legislature, because we were worried about the impact of that uncompensated care, we were worried about our rural providers closing.

And now all those worries are back on the table.

But on top of that, you have millions of Americans, a third of them children, who are losing food assistance, who are also going to be losing access to free and reduced lunch in schools.

And so you'll have hungrier Virginians, you will have sicker Virginians all so [that] the top wealthy can get a little bit richer.

ADRIENNE HOAR McGIBBON: There were expectations that the legislation could impact Medicaid expansion by changing the amount that the government was providing and funding to states.

That didn't happen.

So how could people on Medicaid expansion be impacted?

JENNIFER McCLELLAN: So the two biggest ways is now if you're part of the expansion population and you make up to $300 a week, you will have to pay up to a $35 copay every time you go see a doctor.

And what that means is somebody who also has to pay rent, pay utilities, put food on the table, who now probably won't have access to SNAP benefits, they're not going to go to the doctor and pay that copay.

They're going to use that to put food on the table.

And as a result, they're not going to get care and when they show up in the emergency room we will pay the rest.

The other piece is now you will have to prove that you are working and go through these red tape requirements that Virginia does not have a process set up for it to do automatically.

And when the states were allowed to put work requirements in place, only two of them did it.

Arkansas kicked 18,000 people who were eligible for Medicaid, who were working off of the rolls because they couldn't prove they're working through their cumbersome process.

And then when you're kicked off of Medicaid, you won't be able to get access to the subsidies to buy through the exchange.

And so you're going to go uninsured, and we're going to have that same uninsured gap that caused rural hospitals to almost close, and blow a hole in the state budget.

The states going to have to decide does it put in the money to pay the difference, when it's also seeing other cuts?

Now, for the first time, the state has to contribute to SNAP benefits and has to fill in gaps from other federal funding as we're seeing the federal workforce, with Virginia being the second highest number of federal employees, now no longer working and contributing to the tax base.

So it's going to blow a hole in the state budget, it's going to leave many Virginians uninsured, and it's going to devastate our health care system on top of everything else in the bill.

ADRIENNE HOAR McGIBBON: Republicans have said that these cuts will help protect Medicaid for future generations.

What's your response to that?

JENNIFER McCLELLAN: They did nothing to address the real cost of Medicaid, which is the fact that people are living longer and need more long-term care.

The cost of prescription drugs going up, they didn't do anything to address that.

They didn't invest any of this back into the health care system to strengthen Medicaid.

All of the money went to tax cuts the bulk of which benefit the top wealthiest Americans.