HARRISONBURG — While many may view the rejection of four Medicaid-related bills as foreshadowing the chances of expansion this year, state Sen. Emmett Hanger said the votes stirred up attention to the issue.
On Thursday, the Senate Education and Health Committee rejected four bills, including Hanger’s SB 572, related to Medicaid expansion by a 8-7 vote down party lines.
Hanger, R-Mount Solon, said he was not surprised by the outcome, given most of the Republicans who opposed the bills have never supported expanding Medicaid, a jointly run state and federal program that provides health coverage mostly for low-income people.
Under the Affordable Care Act, states can expand Medicaid to more low-income residents, but the GOP-controlled General Assembly blocked Democratic efforts to do so.
In his last budget proposal, outgoing Gov. Terry McAuliffe said expansion would “unlock” $3.2 billion in federal funds in the 2019-20 biennium.
Republicans, however, say the federal government could pull its funding for the program, leaving the state to either oust the roughly 300,000 to 400,000 people who could be covered under the expansion or take on the entire program’s expense.
Hanger said his best chance is to introduce an amendment during budget negotiations. He filed a bill sooner to try to drum up support before then.
He said he hopes there will be more educated talks about the issue this General Assembly session, rather than the normal partisan discussions.
“Some members are more receptive to doing something now than before,” he said. “Before, there was just a lot of rhetoric about Obamacare, and a lot of that just came from the fact that they didn’t care for President [Barack] Obama.”
Medicaid expansion is more plausible this year because of the substantial party shift in the House of Delegates. After the November election, Democrats claimed 15 seats, narrowing the Republican majority to 51-49. In the Senate, Republicans hold a 21-19 advantage.
Hanger’s bill, and future budget amendment, would expand Medicaid and require recipients to work, if able, and pay a small amount at the doctor’s office that would be determined on a sliding scale.
State Sen. Mark Obenshain, R-Rockingham, said he does not believe expanding a “broken Medicaid system” is the way to improve health care in the commonwealth.
“I think we all share a common goal ... to expand access to health care,” he said. “I think our disagreement is over how to do it and what the most pressing problem is.”
Obenshain would prefer the state focus on lowering “skyrocketing” premiums instead, he said. He’s heard from many insured families in the Shenandoah Valley that struggle to pay for health insurance.
Expansion would help the state cover more lower-income and mentally handicapped people, Hanger said, many of whom are not insured and may not be able to afford it.
Uninsured people cannot be turned away from emergency rooms, regardless of their ability to pay. Their medical expenses then fall on the rest of the population to pick up, Hanger said, which makes health care more expensive for the insured.
Once more of the uninsured people are covered, he said, the drain on the health care system will lessen and allow the insurance marketplace to stabilize.
If the federal government cuts Medicaid funding, Hanger said, Virginia will roll back its program. Even if the state can provide coverage and help families for a year or two, he said, the amount of good that could be done would be worth it.
“I don’t think it’s a valid argument to say that they can’t do it because it might not last forever,” Hanger said, “because nothing lasts forever, particularly when the federal government is involved. We just have to do currently what we can do with the program in a positive way.”
Del. Steve Landes, R-Weyers Cave, said members of Congress may try to repeal the Affordable Care Act as one of their last moves before midterm elections in November. Republicans failed to repeal the law last year, despite controlling the U.S. House of Representatives and Senate.
Landes would prefer the General Assembly remain cautious about expanding in the meantime.
Hanger said time will tell whether he is able to convince a few Republicans to vote for his budget amendment, but he’s received support since his bill failed.
“We need to make sure we’re educating people appropriately,” Hanger said, “and that they take action to help us make that argument.”