Southwest Virginia families have suffered through incredible economic challenges the past several years. The jobs in and around the coal industry disappeared with few prospects for new employment. Today, encouraging signs of a diverse economic revitalization are appearing across the region. Industrial recruitment activity is presenting more potential new employers. A nearly two-decade long effort to foster tourism growth now has developed into meaningful activity in several communities. As more and more people across the region are taking the risk to start their own businesses, perhaps we are beginning to see real opportunities for hope. Now more than ever, we must ensure that we have both a skilled and a healthy workforce.

We face real healthy workforce challenges. National and state efforts aimed at addressing the opioid crisis bring much needed attention to this issue that plagues our region. As the Southwest Virginia Health Authority evaluated the proposed merger of our two regional health systems, the data confirmed the seriousness of the health challenges we face — from obesity to the need for improved pre-natal care. Too many Southwest Virginia families struggle for access to health care often out-of-reach due to cost. As a result, preventable health concerns often become serious problems causing employees to miss work and families to suffer even greater financial strain.

It is time to act.

Yes, many in the General Assembly have been reluctant to accept the “free” money from Washington to expand the government-run Medicaid system. Why? As we predicted when Obamacare passed, the costs to state taxpayers for this “free” expansion far exceeded what the Obama administration predicted. According to government reports, the average expansion enrollee costs were 49 percent higher than originally projected. Because of this, the Congressional Budget Office had to increase its 10-year cost projection for Obamacare’s Medicaid expansion by $136 billion. So, this “free” money was not free, and the taxpayers of the states which did the expansion are now having to pay some of these costs.

Our concern for protecting Virginia taxpayers and our reluctance to embrace this “free” healthcare has caused Southwest Virginians to be criticized for “voting against their own interest.” We recognize that statement assumes we are too driven by cultural issues to be selfishly motivated and accepting of government hand-outs. In fact, the comment entirely misses the mark.

People who say these things about us don’t know us very well.

For generations, we have happily worked some of the most dangerous jobs in the nation and in Virginia to provide a better life for our families —and power for a growing nation. When the national economy soured, and our way of life came under attack, we never asked for a hand-out, only a hand-up. It’s who we are. Neighbors help neighbors. Congregations help fellow members. Families support each other. We believe able-bodied people ought to be encouraged to work and to help those of greater need.

Our neighbors in the Commonwealth of Kentucky recently enacted, with the support of the Trump Administration, the nation’s first requirement that able bodied adults receiving Medicaid assistance should work or seek opportunities to gain the work skills necessary to find and secure a job. Kentucky, the Trump Administration and an increasing number of other states, believe that the best way to get real insurance coverage, and the best way to improve economic opportunity, is for able-bodied adults to have a job with the opportunity to grow income and secure their family’s financial future.