Gov. Bob McDonnell (R) is getting plenty of unsolicited advice as he mulls what to do about the federal health-care law recently upheld by the Supreme Court.
Democrats in the state’s House of Delegates called on the governor Thursday to move forward to create a health benefits exchange, an insurance marketplace through which Virginians can obtain coverage under the law.
States must either create exchanges of their own or accept a system created by the federal government. If the law continues to stand and Virginia needs an exchange, McDonnell has said he’d much prefer a home-grown system, not one handed down from Washington. But he also has suggested that Virginia might want to wait out the presidential election, since Republican Mitt Romney has vowed to get the law repealed if elected.
With deadlines for implementing the exchange looming, House Democratic Leader David Toscano of Charlottesville and Democratic Caucus Vice Chair Jennifer McClellan of Richmond urged McDonnell to move ahead — by applying for federal grant money for planning the exchange or by convening a special General Assembly session to authorize its creation.
“If the Commonwealth does not apply for federal funds intended to help implement the Virginia Exchange, we could get the worst of both worlds,” McClellan said. “The very last thing we need is for the federal government to impose an exchange on us because we are not ready by the end of this year,”
Also Thursday, Lt. Gov. Bill Bolling (R) sent McDonnell a letter urging him not to expand Medicaid. While upholding the law last month, the court ruled that the government cannot withdraw existing Medicaid funding from states that opt against a big expansion of Medicaid eligibility. Bolling said Virginia should take advantage of the opportunity to opt out.
“I am writing to advise you of my opposition to expansion unless it includes fundamental and substantive reform of the current Medicaid program,” Bolling wrote. “Expanding Medicaid under the ... [law’s] requirements would add an estimated 425,000 additional people to Virginia’s Medicaid rolls. The estimated cost of such an expansion would be $31.3 billion over the next 10 years, with Virginia’s share being at least $2.1 billion. ... Funding such a significant expansion of Medicaid would place tremendous fiscal pressure on the Commonwealth and divert funds from other state programs, such as public education, higher education, public safety, natural resource protection and even other critically important health care programs.”
The statements from Democrats and Bolling come two days after McDonnell sent a letter to legislators saying that he was still considering whether to opt out of Medicaid expansion. He said flatly that he would not call a special session and indicated that he was not interested in setting up an exchange anytime soon.
“With multiple unanswered questions and great uncertainty, it is not prudent to spend a great deal of time and taxpayers’ money on building a system that we may never need to implement or that may be materially different once the rules are finally established,’’ McDonnell wrote.