Local doc goes on hunger strike to support state funding of Medicaid expansion

“I’ve made my voice heard and that’s a start,” said Greg Gelburd, a local physician who fasted to bring attention to Medicaid expansion. Photo: Ash Daniel “I’ve made my voice heard and that’s a start,” said Greg Gelburd, a local physician who fasted to bring attention to Medicaid expansion. Photo: Ash Daniel

Dr. Greg Gelburd was watching a local screening of the film Jesus the Man when he had an epiphany about Medicaid expansion in Virginia. “I started to focus on the message of the film,” said Gelburd, a devout Christian and family medicine physician who believes providing affordable health care to the working poor is a moral imperative. He’d been dismayed when the U.S. Supreme Court removed the Medicaid expansion mandate from the Affordable Care Act (ACA) in June 2012, a ruling that enabled Virginia and 20 other states to deny the expansion, and watching the film, he felt an urge to get more directly involved.

“First, I thought, I could just put in a letter to the editor,” said Gelburd. “Then I thought, that’s not enough. I could fast. I could go down there.”

On Thursday, March 6, two days before the Virginia legislature wrapped up its 2014 session, Gelburd stopped eating, and, after clearing his schedule at his Garrett Street practice, drove to the state Capitol where he sought out conversations with Republican lawmakers. He was hoping to understand their objections to expanding Medicaid coverage to the estimated 400,000 working poor in Virginia who fall into the gap between current Medicaid coverage and insurance policies now available through the ACA health care exchange.

“It’s a personal attempt to bend the thoughts and decision making of people who are opposed to expanding Medicaid,” said Gelburd.

One of those people is local Delegate Rob Bell, and in an interview on Monday, March 10, two days after the General Assembly adjourned without a decision on expansion or the state budget, the Republican lawman explained his position.

“The program as constructed is not sustainable,” said Bell, who criticized the Medicaid expansion for taking money from other tax-supported state resources including schools, roads, universities, and prisons.

Bell, who had not yet met with Gelburd but planned to this week, said he and other Republicans are also concerned that even if the federal government fulfills its promise to pay 100 percent of the states’ costs for three years and 90 percent thereafter, the additional expense to the state would be too burdensome. He said he was aware of the health care hardships facing the working poor, but suggested there are affordable health care options for them.

“There are free clinics and other ways they can get it,” he said.

Poor patients aren’t the only ones clamoring for Medicaid expansion, of course. Gelburd cited testimony from hospital administrators including UVA Medical Center CEO R. Edward Howell.

“Here’s Ed saying we’re going to lose $100 million to $122 million this year because you’re not expanding Medicaid,” said Gelburd, noting that Virginia taxpayers are already paying for the Medicaid expansion but are getting nothing in return.

“I know that they believe what they’re saying,” he said of Republicans, “but I don’t get the math at all.”

At presstime, Governor Terry McAuliffe had scheduled a special legislative session on March 24, but Bell didn’t believe progress would be made unless the Medicaid expansion issue was decoupled from the budget.

Gelburd, who ended his hunger strike on Saturday, said he planned to keep pushing for expansion.

“I’m hoping that the stories I share of the people in my practice go past the intellect and straight into the heart so they clearly hear what people in Virginia are facing without health insurance,” he said.