Democrat Terry McAuliffe favors a Medicaid expansion wholeheartedly. He says it would provide new health-care coverage for about 400,000 Virginians and would increase money for mental health treatment.
Republican Ken Cuccinelli II opposes a Medicaid expansion completely and says McAuliffe’s estimates of its effect on Virginia are greatly overstated. Cuccinelli wants to increase state funding for mental health, but he would do so by shifting current Medicaid funds from other health-care areas. He also said he would target waste, fraud and abuse and use the savings to bolster options for the mentally ill and the intellectually disabled.
Cuccinelli has been personally involved with the mental health system. As a newly minted lawyer, he began volunteering to represent people with mental illness in civil commitment hearings. As a state legislator and attorney general, he worked to improve the commitment system, both after the 2007 Virginia Tech shootings and after a friend and neighbor, Fairfax County police officer Michael Garbarino, was fatally shot by a mentally ill teenager in 2006.
After the Virginia Tech shootings, in which a mentally ill student from Fairfax killed 32 students and teachers in 2007, the state General Assembly passed reform legislation. The emergency evaluation process improved; the standard for involuntary commitment was eased; mandatory treatment rules were tightened; and community mental health services were better funded.
But Virginia cut its budget for mental health services by 9 percent between 2009 and 2011, according to the National Alliance for Mental Illness. In Fairfax, the most populous jurisdiction in Virginia, the Community Services Board, which handles many cases of mental illness, lost $16 million in funding in the past five years.
Recent high-profile incidents in the District — including the Navy Yard shootings and the police shooting of a woman who appeared to try to breach security at the White House and U.S. Capitol — have cast a spotlight on mental health issues nationwide.
Although Cuccinelli’s platform seeks to cut state funding in many areas, he wrote, he took a different tack in a five-page analysis of the state's mental health system. “We need to actually commit to spending money on mental health reform,” he wrote. “This is an area where I am willing to invest funds to develop a high quality care program.”
McAuliffe estimates that accepting the Medicaid expansion would bring in $21 billion in federal funding and free up $500 million from the state’s general fund over four years.