Virginia’s Medicaid war shifts from Capitol to cities and towns across the commonwealth

An insurance agent stood on a busy street here Wednesday and, over the whoosh of passing cars and the beep-beep-beep of nearby construction equipment, quoted Edmund Burke, Ayn Rand and “fuzzy” White House math.

It was just another day in Virginia’s Medicaid war, which in recent days decamped the deadlocked Capitol for cities, towns and rural enclaves across the commonwealth.

Legislators left dug-in Richmond on Saturday after an impasse on Medicaid expansion prevented the passage of a state budget. They return March 24 to try again in a special session. That gives them two weeks to beat the drum for or against Medicaid expansion and to line up support from mayors, business leaders and ordinary Virginians.

Gov. Terry McAuliffe (D), who visited all 23 of the state’s community colleges during his election campaign in the fall, is now on a pilgrimage to hospitals around Virginia.

With an intensity rivaling the frenzied finish to the gubernatorial race, he and a top surrogate have been visiting hospitals to highlight how Medicaid expansion would help those institutions and the communities they serve. Between the two of them, they have hit six hospitals in the past two days, including a trip by state plane Tuesday to Tazewell County in southwest Virginia. McAuliffe is due to appear at a health center in Manassas on Thursday.

“The Governor has been traveling across the Commonwealth, visiting hospitals, clinics, and meeting with healthcare providers and patients to hear how important closing the coverage gap is for our health care facilities’ bottom lines and for the health of our citizens,” McAuliffe spokeswoman Rachel Thomas said via e-mail.

Expansion opponents, led by House Speaker William J. Howell (R-Stafford) and House Majority Leader M. Kirkland Cox (R-Colonial Heights), are spotlighting small-business owners hurt by the federal health-care law at the heart of the Medicaid debate.

On Wednesday, Colonial Heights insurance agent Frank Lundie stepped up to offer his story at a news conference in front of his business. He said he had been reluctant to speak but had to, given what Burke said in the 18th century: that evil triumphs “when good men do nothing.”

Lundie went on to say that the premium on his personal insurance plan doubled and his annual deductible rose by $2,000 as a result of the law. The Affordable Care Act led to the cancellation of millions of existing insurance policies, he said, so even by the White House’s “fuzzy math,” more people lost insurance than got it.

His complaints centered on problems with the broader health-care law, not Medicaid expansion per se. But Lundie and Republican leaders argued that the law’s well-known flaws are reason enough to resist expansion.

“The hardest thing to explain is the glaringly evident which everybody has decided not to see,” Lundie, quoting Rand, told about 50 politicians and business leaders at the gathering.

McAuliffe and a majority of the evenly divided state Senate are determined to expand Medicaid to 400,000 poor and disabled Virginians. The Republican-dominated House is equally bent on blocking expansion.

Supporters say expansion would aid needy Virginians and create about 30,000 new jobs, helping to diversify an economy that is perilously dependent on defense dollars and other federal spending. Opponents contend that Washington — already so overextended that it is paring back on defense — does not have the money to make good on its promise to pick up most of the tab, which in Virginia would amount to about $2 billion a year.

Their disagreement has stalled passage of the state budget because the Senate included Medicaid expansion in its two-year, $96 billion state spending plan. Republicans have called for the expansion plan to be stripped from the budget so that it can rise or fall on its own merits, but the Senate has not wanted to surrender that leverage.

The impasse could lead to a shutdown of the state government if it is not resolved before the start of the new fiscal year, July 1. Any delay makes it hard for local governments, school boards and universities to set their own budgets because they do not know how much funding they can count on from Richmond.

Laura Vozzella covers Virginia politics for The Washington Post.
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