A Mile Away, Worlds Apart

Fishersville Events Show Medicaid Chasm Between Governor, GOP

Posted: March 3, 2014

Gov. Terry McAuliffe (left) talks with Kelly Manor, manager of the Augusta Health cath lab, during a tour on Saturday in Fishersville. (Photo by Preston Knight)

FISHERSVILLE — A mile separates Augusta Health and Eavers Tire Pros, the sites of a pair of political events Saturday afternoon.

But for the lawmakers who spoke about the state budget at the two locations, they might as well have been a world away.

Democratic Gov. Terry McAuliffe brought his campaign to expand Medicaid to Augusta Health, while three House Republicans responded with their own event at Eavers. McAuliffe wants to use federal funds to expand Medicaid to cover more than 400,000 more Virginians. The GOP says reform to the healthcare program should come first.

The events came as senators and delegates work on a $96 billion biennial budget, one that, according to the House members, has only a $26 million difference left to cover between the Senate’s and House’s preferences.

But the question of expanding Medicaid, the biggest partisan divide of this General Assembly session, remains. Medicaid serves low-income families with children, as well as the disabled and others who qualify.

“It’s hard when one chamber [the House] won’t even talk to you,” McAuliffe said during a roundtable discussion with doctors and hospital personnel. “Keep the politics out of it. Do what’s right. … This is as big of an issue as we’ve faced in a long time. As you can tell, I’m passionate about this. As governor, I should be.”

At Eavers, Del. Steve Landes, R-Weyers Cave, said McAuliffe has not given enough guidance to those working on the budget, and has instead been campaigning around the state, primarily touring hospitals.

He said McAuliffe’s claims that the House continues to say “no, no, no” to compromise are “a bunch of cockamamie comments” from the governor.

“I’ve been doing this for 19 years. I have never seen a governor not engaged in the process like this man has been,” Landes said to about 40 people at an event sponsored by the National Federation of Independent Business, “…  and I realize this is his first elected office he’s ever held.”

Legislators face a March 8 deadline — when the General Assembly session ends — for a budget deal, but they can work past that date to reach an agreement before the next fiscal year starts July 1. Any delay past March 8 will likely be because of Medicaid expansion, political analysts say.

McAuliffe said he is “insistent” that the budget the General Assembly presents him includes expansion of the program that currently costs $7 billion a year in Virginia. Under the Affordable Care Act, commonly called Obamacare, the federal government will pay for the first three years that states expand, and then no less than 90 percent after that.

Most Republicans say the federal government cannot be trusted to fund the program.

One of the striking aspects of the Saturday events were that both McAuliffe and the House Republicans — Landes and Dels. Ben Cline, R-Rockbridge, and Dickie Bell, R-Staunton — made similar points, if not using the exact same language at times.

Both spoke of a “Virginia way” toward Medicaid expansion. Both said they want to take “Washington-style politics” out of the conversation. Both said that after General Assembly members go home to hear from constituents, they will realize what people want: McAuliffe is convinced that is expansion, while the delegates say it’s anything but.

And both said the other’s position would jeopardize other services. Through expansion, the federal government cannot be trusted to pay its end, Republicans say, meaning the state will have to take funds from areas such as education and public safety to fund Medicaid.

“Typical of a Washington-style program, Medicaid [costs] over the last 30 years [have] grown by 1,600 percent,” Cline said. “We are holding firm on Medicaid expansion. We need to reform it first. …  It’s rhetoric like [McAuliffe’s] ‘insistence’ that doesn’t help the process.”

But, if expansion doesn’t happen, hospitals will have to cut services, if not close in some cases, because of the costs of treating the uninsured, McAuliffe and Augusta Health officials said. That would hurt job growth and Virginia’s business appeal, the governor said.

If Republicans are that worried about the federal government’s finances, the state can write its legislation for expansion in a way that addresses changes after three years, the governor said.

“We are open to any creative way to getting this done,” McAuliffe said.

He said it was time to bring Virginia taxpayer back to the state, adding that the uninsured will still continue to visit hospitals. New numbers from the Department of Medical Assistance Services show that instead of costing the state money, expansion would save the commonwealth $1 billion through 2022, McAuliffe says.

“What’s your argument next?” McAuliffe said, as if addressing opponents.

The Republican delegates say the solution has already been approved — through the Medicaid Innovation and Reform Commission, which was formed last year to oversee reforms and mull the question of whether to expand.

“We have not completed our work,” said Landes, the panel’s vice chairman.

Despite the back and forth, delegates think they still can have a budget deal by the end of this week.

Contact Preston Knight at 574-6272 or pknight@dnronline.com

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