By Rosalind S. Helderman
Washington Post Staff Writer
Sunday, October 4, 2009

With debates about health care raging in Washington, Virginia's candidates for governor both have advanced state-level plans to improve the care of the commonwealth's citizens. They also have parted ways on federal reform efforts.

Robert F. McDonnell (R) has said that he is opposed to Democrats' efforts to reform the health-care system and that a public option for health coverage would represent a government takeover. He also opposes a legal mandate that individuals be covered.

State Sen. R. Creigh Deeds (D) has said that Congress needs to find a way to reform the system so that more Americans have insurance and to bring down the costs of care. He said that he believes a public option is one way, but not the only way, to accomplish those goals and that he supports a mandate on individuals if aid is provided to small businesses to help them cover their workers.

At the state level, both candidates support the creation of basic health-care plans that don't offer coverage for all services now mandated by state law, one that businesses with fewer than 50 employees could offer their workers. They both also say they would focus more attention on adoption of electronic claims and increasing wellness and preventive care to lower health costs.

McDonnell has emphasized examining Medicaid for cost savings, including reexamining payment rates and eligibility for enrollment, although he has acknowledged that Virginia already has some of the toughest enrollment standards in the country. He also proposed encouraging the use of health savings accounts and raising the cap on how much can be contributed to the accounts tax-free each year.

He also has proposed increased funding to community health centers and free clinics and maintaining Virginia's $2 million cap on malpractice verdicts. And he wants to expand community-based mental health care options.

To encourage residents to purchase long-term care insurance, he also has proposed doubling a tax credit of 15 percent of premium costs.

Deeds has proposed expanding the state health-insurance coverage of low-income pregnant women, children and the unemployed. He has recommended offering loans to temporarily unemployed workers to cover the costs of COBRA insurance.

He also proposes an aggressive effort to enroll all eligible children and pregnant women in FAMIS, Virginia's health-insurance program for low-income people who earn too much to qualify for Medicaid. He also would add dental coverage to FAMIS, at a cost of $3.1 million, and expand eligibility for pregnant women from those earning 185 percent of the poverty line to those earning 200 percent of the poverty line, a proposal that would cost $1.6 million.

Deeds also would provide small businesses a $1,000-per-employee tax credit if they pay at least 50 percent of their employee's health insurance premiums.

And Deeds supports prohibiting insurers from denying care for preexisting conditions and mandating that insurers cannot retroactively cancel policies when patients are not at fault.