Each week, my colleague Stephanie Glover and I take a short trip to Arlington to volunteer as Certified Application Counselors (CACs). We talk to Virginians about the health coverage options available under the Affordable Care Act (ACA) and help them enroll in an affordable comprehensive insurance plan. It is very exciting to meet new clients each week—all of whom are uninsured—who are eager to learn about their options and obtain coverage.

The best part of the experience is enrolling a previously uninsured family into health insurance that meets their needs and fits their budget. Clients leave the office happy and incredibly thankful to the volunteers. The worst part of this experience is telling clients that, unfortunately, they are not eligible to enroll today. I try to explain they are not eligible to enroll in a private plan because their income is below the poverty level which means they do not qualify for federal subsidies and yet they earn too much income (or fail to meet other eligibility criteria) to qualify for Virginia’s current Medicaid program.

Because Virginia is one of 26 states that have not taken federal funding to cover more people in Medicaid, hundreds of thousands of residents fall into this “coverage gap.” Most clients are confused and do not understand why they cannot enroll—they have all of their tax paperwork and other documentation with them, and are ready to complete the process. They leave the office frustrated and disappointed. Some ask what they should do in the meantime. Others say they will check with the Medicaid office in the summer to see if anything has changed.

State lawmakers can and must act now to extend health coverage to roughly 400,000 Virginians.

It’s good for Virginia

The ACA explicitly includes money for each state to cover more people through Medicaid. The federal government will pay 100 percent of benefit costs through 2016 and at least 90 percent of the costs after that. By accepting the federal money and closing the coverage gap, Virginia could save $424 million [PDF] dollars in uncompensated care costs over the next ten years. Closing the coverage gap will also bring in $14 billion of federal funding into Virginia [PDF], helping to keep hospitals open and available in local communities. If Virginia accepted the federal money, this coverage expansion would reduce uninsurance in Virginia by 52 percent, when combined with other reforms in the ACA.

Virginia lawmakers must act now

Approximately 271,000 people, including 128,000 women, will remain uninsured because Virginia lawmakers have failed to act. Low-income uninsured women—many of whom would be eligible for health insurance if Virginia accepted the federal money—are more likely to go without care because of cost, less likely to have a regular source of care, and utilize preventive services at lower rates than low-income women with health insurance. Hardworking Virginians are in dire need of affordable health coverage in order to access the care they need to get and stay healthy.

To learn more about the incredible efforts of advocacy organizations and volunteers working to close the coverage gap and get 400,000 people health insurance, check out Virginia Organizing.