Cuccinelli (R), the state’s attorney general, told the crowd that he had worked with the mentally ill as a student, volunteering at a homeless shelter, and as a lawyer in private practice, representing them in involuntary commitment cases.
He said he would find more funding for mental health programs despite his reputation as “a frugal person” and pledge to cut state taxes by $1.4 billion a year. He also said he supported preschool vouchers for low-income children, who are at higher risk for mental illness. And he proposed giving incentives to nursing schools to graduate more mental-health nurse practitioners in order to address a shortage of mental health-care practitioners.
“This is an area that I’m committed to moving dollars over to,” he said.
Cuccinelli also said his proposed tax cut could help alleviate some of the financial stress on families that contributes to mental illness.
McAuliffe, the former Democratic National Committee chairman, spoke of the need to beef up mental health services in schools, improve training for police and jail personnel who come in contact with the mentally ill, and boost the quality and quantity of long-term housing for the severely mentally ill. He said the key to providing those and other services was expanding Medicaid under the federal health-care law, something Cuccinelli opposes.
“All of this takes money,” he said. “The Medicaid expansion money allows us to do what we need to do to take Virginia to the next level on issues of mental illness.”
Under the Affordable Care Act, states have the option to open their Medicaid programs to people with incomes up to 138 percent of the national poverty level — about $32,000 for a family of four — with the federal government paying the full cost for the first three years. The federal share gradually declines to 90 percent. Virginia would initially receive about $2 billion a year from Washington under the program. But some Republicans, including Cuccinelli, have been skeptical that Washington will have the money to make good on that promise.
McAuliffe noted that a number of conservative Republican governors around the country have opted for Medicaid expansion. He said Virginia should not turn that money down.
“We’re already paying in,” he said. “That’s our money.”
Cuccinelli said the Medicaid program needs reform, not expansion. He vowed to continue rooting out Medicaid fraud, as he has done as attorney general, and direct that money to worthy mental health programs.
The crowd gave a noticeably warmer reception to McAuliffe, breaking into applause when he said that he supported Medicaid expansion. But some members of the audience said afterward that they had been impressed by both men.
“Both had a lot of really good things to say,” said CristyGallagher of Alexandria, the mother of an 11-year-old with bipolar disorder. She favors the Medicaid expansion that McAuliffe supports but also liked Cuccinelli’s suggestion to deliver some mental health services through schools.