Virginia will soon become the 33rd state to expand Medicaid under the Affordable Care Act. Last week, the state Senate voted to expand the Medicaid program as part of the state’s budget. Following the Senate vote, the House of Delegates approved the measure, sending the bill to Gov. Ralph Northam’s desk who is expected to sign the budget in the next few days.

There are similar efforts underway in Utah and Idaho. Medicaid expansion advocates in Utah collected enough signatures this week to put an initiative on the ballot this November and organizers in Idaho are working to do the same.

Sadly, Medicaid’s poor standard of care has resulted in inferior medical treatment for those who need it the most. Under the Affordable Care Act, states are encouraged to expand their Medicaid programs, with the federal government covering 90 percent or more of the cost through 2020. Consequently, the Affordable Care Act has resulted in large increase in Medicaid enrollment, with many states adding able-bodied adults to the program, crowding out services for vulnerable groups who rely on the program such as the elderly and disabled.

Medicaid was designed for the most vulnerable Americans, not able-bodied adults. Furthermore, many of these new enrollees would be better served by private, less expensive insurance plans with greater choices.

Rather than expanding Medicaid at the expense of those who depend on the program, lawmakers should focus on policies that strengthen the Medicaid program by focusing it on those who truly need it.

A new plan to repeal and replace the Affordable Care Act, which builds on the Graham-Cassidy bill introduced in the Senate last year, is expected to be released sometime this month. Importantly, the plan proposes sending money to states in the form of block grants, giving local authorities more freedom to craft programs that will best provide quality care to those in need. The Wall Street Journal reports:

The nascent proposal would end the ACA’s expansion of Medicaid and funnel money to states in the form of block grants. It would likely include some current ACA consumer protections, such as financial assistance to some people who can’t afford coverage, as well as an expansion of health savings accounts.

Backers hope for legislative action on the proposal, which builds on a bill offered last year by Sens. Lindsey Graham (R., S.C.) and Bill Cassidy (R., La.), by the end of August.

“I’m completely supportive of what the outside groups are doing. I will absolutely be a real champion to put that forward,” said Sen. Ron Johnson (R., Wis.), adding that he has yet to see the groups’ proposal. “I think it’s about honoring our promise and fighting hard to do it.”

This would be a major improvement to the status quo. It would give more healthcare power to the states which means deregulating insurance markets away from one-size-fits-all.

Most importantly, this would be good news for the American people, many of whom are hurting under the Affordable Care Act, giving them much-needed relief from the high costs and access to the choices they actually want.