The Opioid Crisis, Cost of Care, Medicaid Expansion

Background:


Access to comprehensive, affordable healthcare is vital to preventing and managing disease, reducing burdens of disability, and promoting the overall health of the population. Not only is equitable healthcare a matter of human rights, but it also creates a more productive and efficient workforce and takes financial burdens off of overburdened healthcare institutions.


Approximately 323,000 Virginians will continue to be uninsured and will still have to rely on free clinics and emergency rooms, while many more will struggle to pay high insurance premiums, even with government assistance. Further still, those who do not qualify for government assistance and do not have an option through an employer will struggle to find reasonably priced insurance coverage. Opioid deaths are still ravaging Virginia, especially in rural areas. We hope that these issues and more will be addressed by the legislature next session.


Looking Back at 2019:


An impressively bipartisan effort to raise the age limit for purchasing tobacco and nicotine vapor products from 18 to 21 passed this year. HB2748 was a direct response to the growing number of teens who are becoming addicted to such products. The US Center for Disease Control has reported that the percentage of high school seniors who have used an e-cigarette in the last 30 days has risen from 11% in 2017 to 20% in 2018. Use at a young age often leads to lifelong addictions. This bill gained particular support from House Speaker Kirk Cox, who was a teacher and is familiar with the mounting number of tobacco addictions.


The legislature also began to tackle what is sure to be a more complex issue in the future: telemedicine. Telemedicine is the practice of remotely caring for a patient, generally through videoconferencing and internet and phone communications. This has the potential to expand access to medical services, especially primary care services. While this industry will certainly require careful regulation, it seems to be an important step towards opening access to healthcare. 


Medicaid Expansion


Medicaid expansion was historically a partisan issue in Virginia, preventing its passage when it first became available. After years of opposition, four Republican senators crossed party lines and Medicaid expansion was approved in 2018 and took effect at the beginning of this year. Traditional Medicaid only offers coverage to children, mothers, and pregnant women. The expanded services offer health coverage to all adults earning up to 138% of the poverty level. Prior to the expansion, those most in need of health coverage were excluded. Low-income individuals are more likely to develop hypertension, diabetes, and cancer, as well as additional mental health concerns. Since the beginning of this year, 325,092 Virginians, who were previously without any healthcare, have enrolled in Medicaid.


Cost of Care


Despite the successful expansion of Medicaid, there are still hundreds of thousands of Virginians left without access to affordable healthcare. Those who do not qualify for Medicaid but do not have the means to pay for comprehensive insurance are stuck in this healthcare gap. Many individuals have poor coverage with high deductibles or no insurance at all. The effects of this can be seen by the 36,000 lawsuits the University of Virginia Health System has filed in the last six years to recoup the high cost of medical services from the underinsured and uninsured. Many face financial ruin resulting from these lawsuits. This coverage gap should be addressed by the legislature in order to create a healthier and more equitable Virginia.


Prescription Drug Costs


Drug prices continue to rise far faster than the rate of inflation. The average annual cost of a brand-name drug has more than tripled in the past decade, jumping from $1,868 in 2006 to $6,798 in 2017, according to the AARP Public Policy Institute. The legislature will have to determine ways to moderate these price increases. Some options for mitigating these costs could come through negotiated prices for commonly used drugs, price caps, transparent pricing, or other solutions. 


Mental Health and Disabilities


Virginia has seen a significant increase in those seeking mental health services from hospitals and psychiatric facilities. However, the state has not sufficiently allocated the resources to increase these vital public resources. The result is dangerous overcrowding at state facilities and overburdening of private facilities.  


Autism has also emerged as an important issue. The prevalence of autism has increased significantly in recent years, with studies showing a rate of 1 in 59 children identified with autism spectrum disorder. Public healthcare and public education are ill-prepared to deal with the needs of this growing population. Virginia must step up to address these issues and advocate for this community. There are many ways for the legislature to do this, for instance, early intervention programs, funding for additional resources, and tax credits for businesses that hire people with autism. 


By VOW Ops March 9, 2026
Power bills are going up in America and the people are angry. They know whom to blame—the bosses of technology firms thirsting for more juice to fuel artificial-intelligence data centres. Ashburn, a town of 45,000 in a featureless part of Virginia that has earned the nickname “Data Centre Alley”, has some 150 of these. They consume roughly as much electricity as Philadelphia, a city of 1.6m. On March 4th Donald Trump convened tech leaders to sign a pledge to “build, bring or buy their own power supply…ensuring that Americans’ electricity bills will not increase”. Their solemn pledges notwithstanding, the chief executives can do little to contain prices. That is not, though, because AI is unstoppable. It is because the AI boom is not chiefly to blame for the rising costs. In the past few years retail electricity prices have indeed outpaced overall inflation (see chart 1). And data centres are gobbling up more power. Goldman Sachs, a bank, reckons that they will account for nearly half of the overall demand growth in America in the coming years. Yet even bullish forecasts put data centres’ share of total demand at only a fifth in 2030. Today it is less than a tenth. A study last year by the Lawrence Berkeley National Laboratory showed that data-centre load was not the main cause of the rate rises in the five years to 2024. It fingered grid upgrades and rising costs of power-generating equipment and raw materials such as copper. Wood Mackenzie, a research firm, estimates that last year demand for distribution transformers outstripped supply by 10%. For power transformers the gap was 30%. Manufacturers report waiting lists for essential grid-related kit stretching to 120 weeks or more, up from 50 weeks in 2021. Many prices started going up in early 2021, nearly two years before the launch of ChatGPT ignited the AI boom. They are likely to keep rising for non-AI reasons. The Edison Electric Institute, which represents private-sector utilities, predicts its members’ cumulative capital spending will reach $1.1trn between 2025 and 2029, up from $765bn in the previous five years. More than half the sum for distribution and transmission infrastructure will go on replacing ageing equipment and hardening it against extreme weather made likelier by climate change. Between 2019 and 2023 big Californian utilities spent $27bn just on mitigating wildfire risk. These investments have been neglected for years. Now, says an industry bigwig, AI provides a pretext to help win approval from regulators to pass the cost on to consumers. And these are not the only non-AI cost pressures. Even before the war in Iran caused natural-gas prices to rise, analysts were predicting that domestic buyers would be increasingly competing with foreign ones as more export terminals for liquefied natural gas come online. Mr Trump, an inveterate renewables sceptic, has not helped by impeding the growth of solar and wind capacity. Peter Fox-Penner of the Brattle Group, a consultancy, notes that as a result prices are rising needlessly for the cheapest forms of new power generation. AI may even be lowering prices. The tech giants are already investing in their own capacity (mostly, whisper it, in the clean variety). Microsoft has signed a long-term deal to restart a nuclear reactor at Three Mile Island to supply its data centres. Meta has backed a handful of nuclear startups. In December Google’s corporate parent, Alphabet, paid $5bn for Intersect Power, a developer of utility-scale solar power and battery storage. A data centre in Ashburn belonging to Equinix, a big operator, is experimenting with fuel cells. Besides adding its own supply, big tech is making existing capacity more flexible. Google has agreed to novel tariff arrangements with Indiana Michigan Power, a midwestern utility, whereby its data centres can reduce their consumption when other demand is high. Microsoft is going further. In one of its Irish data centres it uses backup batteries as a “grid stabiliser” that can push power back into the network or draw excess power from it at times of stress. Since grids often run well below full capacity, adding a large, flexible customer can bring in lots of revenue for utilities without requiring costly expansion. This lets the utilities lower rates for households while preserving their margins. The Electric Power Research Institute, a think-tank, found that some states with high load growth between 2019 and 2024 reported price declines, after adjusting for inflation (see chart 2). The World Resources Institute, another think-tank, notes that in North Dakota rising demand from oil and gas extraction, cryptocurrency miners, data-centre operators and food-processors led to large price reductions for local electricity users. PG&E, a big Californian utility, estimates that adding a gigawatt of load could lower bills by up to 2%. If Americans want lower electricity bills, they should be shouting for more AI, not less. Original article can be found here .
By VOW Ops January 21, 2026
The second year of results from Virginia’s recently established Quality Establishment and Improvement System (VQB5) for early childhood education found that 99% of childcare providers receiving state funding meet or exceed quality expectations. As of early December 2025, over 154,000 views have been recorded on the system’s website since its October 2024 debut, revealing the many parents and families who appreciate the information that VQB5 offers them. None of these wonderful results would even be available to admire without the support and success we had in passing HB 1012 and SB 578 back in 2020! The data focuses on classroom interactions between children and caregivers and notes how said interactions encourage kids to express themselves at a young age. The state has also enacted categories of excellence for providers who score in the top 10%, exceed quality expectations, or even show significant improvement from an evaluation the year before. On top of that, a new data system called VAConnects helps integrate information on students over the years to track their learning progress. The Department of Education wishes to sustain the program and has requested $735,000 to do so. Overall, Virginia is serving as a model for other states to use in establishing best practices for their early childhood programs. Read more here .
By VOW Ops January 21, 2026
An August survey reveals that large majorities of Virginians want state lawmakers to address the rising cost of housing. The survey was conducted by Housing Opportunities Made Equal of Virginia and Freedom Virginia. More than 8 in 10 Virginians said the General Assembly needs to act. More than 3 in 4 Virginians want lawmakers to prevent landlords from raising rents each year by more than 7%. Many Virginians also supported the idea of the state incentivizing localities to build more housing and providing developers with an ability to appeal rejected housing projects. Many proposals that were made to address all these public concerns were struck down during the 2025 legislative session. One of the main reasons why all the mentioned proposals failed to pass the General Assembly is because of the large influence the local government lobbies have in Richmond in protecting what little authority they are granted by the state. However, 6 in 10 Virginians indicated that they are more concerned with providing more housing than protecting local government authority. Read more here.
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