Kaine Proposes Millions For Health

An additional $50,000 annually would go to a nonprofit organization that offers dental care to the uninsured, an issue particularly important in rural Virginia.

Although Kaine cautions that his proposals are the first steps in a multiyear process to expand access to health care, Virginia's efforts fall short of initiatives being debated or implemented in other states.

Last month, Maryland Gov. Martin O'Malley (D) and state legislators agreed on a plan to raise the state's cigarette tax by $1 to expand Medicaid coverage to 100,000 uninsured residents. An estimated 800,000 people lack insurance in Maryland.

In New Mexico, Gov. Bill Richardson (D) is pushing a proposal to offer universal health coverage, at a cost of $333 million over five years.

Four states -- Hawaii, Maine Massachusetts and Vermont -- have approved programs that come close to universal health coverage, according to Laura Tobler, program director for the health program at the National Conference of State Legislatures.

But Kaine is juggling a host of competing needs, including more funding for mental health programs after the Virginia Tech massacre.

Kaine has ruled out seeking a tobacco tax increase to pay for health care because the tax was raised three years ago. He also pushed for a tax increase last year to pay for transportation improvements.

Despite the budget challenges, Kaine stressed that Virginia should take steps toward tackling the problem of the uninsured. "I've got a pie of finite size, and it is a tight revenue time. But even in a tight revenue time, I want to figure out a way to serve more people, especially vulnerable people," Kaine said.

Terry G. Kilgore (R-Scott), chairman of the House Republican caucus, said he supports some of Kaine's proposals but is worried about how to pay for them. "Where will the money come from?" he said. "That's the question all of us have right now."

Tobler said Kaine's modest proposals mirror those in other states with tight budgets.

"To date, most health-care reform and most programs to target the uninsured have been incremental, smaller-scale, simply because of funding," she said.

Staff researcher Meg Smith contributed to this report.