The debate rages in my home state of Virginia about whether we should accept the offer of federal reimbursement to our health care system through expanded Medicaid coverage. Basic health care would be extended by this expansion of the program to a class of Virginians that includes the working poor, and those who are medically impaired but have not yet qualified for Social Security Disability or Supplemental Security Income.

We need to focus for a moment on those who are paying a personal price for our politics of perceived frugality. In my law firm’s disability claims practice, our attorneys see the damage caused to Virginians each and every day by the lack of basic health care.

The denial of Social Security disability benefits is simultaneously a denial of health care coverage under Medicare and Medicaid. At my law firm, we represent hundreds of Virginians who are denied disability benefits. In a successful appeal of the benefit denial, our clients do in the end receive disability benefit payments, with corresponding health care provided through either Medicare or Medicaid. Unfortunately, these appeals can take years. During this appeal time – even though a court ultimately decides the claimant was eligible all along – there is no interim health insurance coverage to provide for desperately needed medical treatment.

Yes, that’s right. The government eventually agrees that these people have been unable to work for months or even years because of illness or injury. They have had inflicted on them the extra punishment of being without basic health care for those same months and years of disabling sickness or injury. We are not talking about coughs and colds. We are talking about disabling medical conditions that go untreated while the legal process grinds its way to eventual justice.

If Medicaid coverage was expanded, there would be at least basic health care available to these thousands of Virginians I have just described.

It is an oversimplified pretense for us to believe that free clinics, emergency rooms and teaching hospitals can provide sufficient care for those who experience this misfortune. I know this because those are the only health care options in Virginia right now for our clients. We provide information about those resources to our clients. They make the telephone calls to get put on the appropriate waiting lists. Months go by. Meanwhile diagnostic testing is deferred, treatment beyond basic pharmacology isn’t provided by free clinics, and while teaching hospitals like MCV have some of the best surgeons around, they can’t operate on everybody who is in need. Surgeries and other medical treatments that might have returned people to work go unperformed. There is a resigned sense of futility in the whole experience.

Our clients are largely working class folks who do have loyal but limited friend and family support networks during the difficult time of their appeals. That support is usually exhausted, however, in providing food, clothing and shelter. Medical care is inevitably deferred as unaffordable. In too many cases, deteriorating health is never recovered.

Should you support Medicaid Expansion in Virginia? I believe the answer is yes. We ought to make the commitment to provide basic health care to all within our borders.

It’s just the right thing to do.