VIRGINIA REPUBLICANS, having been swept from power at the hands of an electorate alienated by their tilt toward extremism, retain just one bastion in Richmond: the state House of Delegates. From that redoubt, they have resorted to political stunts and budgetary gimmicks as a means of derailing Gov. Terry McAuliffe’s proposal to extend health coverage to hundreds of thousands of Virginians by expanding Medicaid. They seem content that the impasse may end in a state government shutdown, from which they evidently hope to gain political advantage by blaming it on Democrats. We doubt it’s a winning strategy for Republicans. It’s certainly a losing strategy for Virginia.
In Richmond, House GOP lawmakers have made it clear they are not interested in compromise, nor do they wish to be bothered much with the facts. Mr. McAuliffe (D), in office barely a month, has tried schmoozing and executive mansion hospitality; he is nothing if not a deal-maker. The Republicans have responded with derision and fighting words. For them, it is enough to demonize Medicaid expansion as a function of Obamacare, and hope the resulting slogans carry the day — no matter what the cost to hundreds of thousands of struggling state residents who have no health insurance.
State Senate Democrats, joined by a few moderate Republicans, have passed a budget that would unlock nearly $7 billion in federal funds to be spent on health care in the Commonwealth over four years. The Senate plan, by extending coverage to hundreds of thousands of the uninsured, would be particularly helpful to hospitals struggling to serve large numbers of indigent patients with charity care; many have been hit hard by funding cuts under the Affordable Care Act. In the Senate’s budget, those hospitals, including Inova Health System facilities in Northern Virginia, would receive nearly $700 million over the two-year-budget cycle beginning this July.
House Republicans, thumbing their nose at the federal funds, would throw the hospitals a bone in the form of $81 million, a comparative pittance. That money would come not from Washington but by cannibalizing the state’s own revenues — in effect, forcing state taxpayers to pony up again for part of what they have already paid for with their federal tax dollars. Without tapping the funds from Washington so that more Virginians have health coverage, some hospitals around the state are in danger of closing. What’s more, officials who have analyzed the Republican House budget tell us that much of the money it would generate for hospitals relies on budgetary sleight of hand.
To demonstrate their resolve, House Republican leaders on Thursdaystaged a vote on expanding Medicaid. In a purely symbolic exercise, all but one GOP member voted it down. In fact, the expansion, one facet in a two-year budget of $96 billion, cannot be extracted from the Senate’s spending plan and killed. Like it or not, Republican conferees from the House will eventually have to sit down with Democratic conferees from the Senate to hammer out a way forward.
Republican lawmakers like to cite the rapid growth in recent years of Medicaid spending as justification for refusing further expansion without what they call major reforms to fight waste, fraud and abuse. In fact, the program has been subject to about 60 audits over the last decade, according to Secretary of Health and Human Services William Hazel, a holdover from the previous administration of Republican Gov. Robert F. McDonnell. In reality, Republicans are far more interested in partisan warfare than a fact-based effort to help the uninsured find coverage and good health care.