Virginia House Republicans Have A Second Chance on Medicaid Expansion

In Virginia, we ask 141 people of tremendous skill – and tremendous ego – to come to an agreement after a period of only sixty days on thousands of bills, how to collect and spend tens of billions of dollars, and how to implement major policy initiatives that will impact millions of people for decades to come.

Forgive me for being unsurprised that there was no budget deal when the time came for the scheduled adjournment of this year’s General Assembly “long session.”

Instead, as has become a familiar tune, the governor of Virginia will call a special session on April 11 to determine how the house and senate can “reconcile” something the governor wants – to expand Obamacare, or Medicaid for working adults, if you prefer that terminology.

But that agreement is not going to be easy.

In a statement announcing adjournment, Speaker of the House of Delegates Kirk Cox, R-Colonial Heights, wrote: “I remain concerned about the long-term fiscal implications of Medicaid expansion, but with a closely-divided House, Senator [Emmett] Hanger’s clear commitment to expanding Medicaid, and the governor’s plan to send straightforward Medicaid expansion back to the legislature, I continue to believe our best option is to craft a plan that guarantees conservative reforms as part of any agreement on healthcare.”

“I recognize some disagree with this approach,” Cox added. “Taking a few weeks away from Richmond will give us the opportunity to begin a fresh discussion on the next steps.”

Perhaps. But he is more than correct that his Senate counterparts disagree and believe the house has left the conservative reservation.

“This budget impasse may prove as difficult to resolve as those that occurred in 2006 and 2014,” said Senate Majority Leader Tommy Norment, R-James City, also in a press release. “With more than $3.3 billion separating the two budget proposals on revenues and over $840 million in differences on spending, I cannot envision how this situation could be resolved quickly.

“I agree with Speaker Cox that the ‘two budgets differ dramatically on healthcare.’ There, however, is where our agreement ends.”

The argument for passing the House version of Medicaid expansion goes a bit like this:

► It covers working adults and adds nearly 400,000 people to the program. It is in line with public opinion. One poll commissioned by the Virginia Hospital and Healthcare Association stated that 83 percent of Virginians favor Medicaid expansion.

► It returns federal dollars to the state that Virginia taxpayers already pay in federal taxes.

► And, for this version to be considered conservative, it receives a waiver from the federal government that the able-bodied beneficiary has to work.

The senate argument is a bit more straightforward: It argues the House version depends on the federal government continuing to fulfill its promise of returning 90-cents on the dollar to the states. They see it as fool’s gold that will cost Virginia taxpayers billions.

“The major difference between the House and Senate proposals is that the House relies on Medicaid revenues in order to produce a balanced budget,” said state Sen. John Cosgrove, R-Chesapeake. “Over the next weeks, the conferees have a tough task. Leaving this session, the Senate is committed to its plan to responsibly produce a budget that provides meaningful healthcare reforms.”

For the entirety of the McAuliffe administration, Republicans resisted the urge to be seduced by federal largesse, but the fright of nearly being relegated to the minority this past November in the House seems to have caused them to significantly reconsider their former opinion on federal spending and limited government.

Unfortunately, now is not the time to play the political odds: There are way too many uncertainties in the federal Medicaid debate for us to think it is responsible to spin the roulette wheel with Virginia’s fiscal future.

Let’s hope the House conferees return to their senses.

This column originally appeared in The Princess Anne Independent News.

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