RICHMOND — Democrats trying to pressure a Republican state senator into supporting Medicaid expansion made good on a threat Tuesday to kill a bill intended to help a shuttered hospital in his poor Southwest Virginia district.
The move inflamed tensions just as the bipartisan honeymoon for newly inaugurated Gov. Ralph Northam (D) seemed to be drawing to an abrupt end.
It triggered emotional speeches on the Senate floor and prompted Republicans to take retribution by revoking their votes to pass a handful of Democratic bills earlier in the day.
"I have never intimated to any of you all, nor have I ever told you, 'Unless you do something for me, I will kill your bill,'" Sen. William Stanley (R-Franklin) said after the measure failed on a 30-to-10 vote — nine Democrats voted for the bill, along with all 21 Republicans. But it was still votes short of the supermajority needed for emergency legislation. "I'm angry. And I'm ashamed of you."
Democrats, who need support from two Republicans to get Medicaid expansion out of the closely divided Senate, said their goal was the same as Stanley's — only on a larger scale.
"I'm angry also," said Sen. Janet D. Howell (D-Fairfax). "I'm very angry that I have constituents — yes, even in Northern Virginia, even in wealthy Fairfax County and Arlington County — that have no health care. They're suffering. A few of them died. ... I think we need to get together to figure out a way we can provide health care throughout the commonwealth and not pick one, small community."
The uproar in the Senate came one day after Republicans and Democrats alike had welcomed newly installed Lt. Gov. Justin Fairfax as the chamber's presiding officer.
After a weekend of bipartisan well-wishes, Republican senators on Monday killed off a slew of gun-control bills backed by Northam. The governor irked them hours later with formal speech that GOP legislators called overly partisan.
On Facebook late Monday night, Stanley said Democrats had threatened to kill or delay a bill to help Patrick County Hospital reopen — unless he agreed to support Medicaid expansion under the Affordable Care Act.
The Democrats' tactics could signal how vigorously they intend to fight for expansion, a top priority for Northam, as it had been for his predecessor, former governor Terry McAuliffe (D).
Like the overwhelming majority of GOP legislators, Stanley has opposed expansion. He played a leading role in blocking McAuliffe's efforts to get around the General Assembly's opposition, pushing a budget amendment in 2014 that blocked the governor's ability to expand unilaterally.
He said Democrats have turned the hospital into a pawn in that fight.
"I'm heartbroken that they would try to pull this stunt on something that has nothing do with what they're trying to achieve," Stanley told The Washington Post. "And I'm not going to stand for it. This is not the time for that fight. That discussion, that debate will occur in this body, but this is not the vehicle for them to try to push through an agenda."
Sen. Barbara Favola (D-Arlington) said Medicaid expansion would benefit the hospital and the state as a whole.
"We would be delighted if Senator Stanley found it within himself to support Medicaid expansion," she said. "The hospital would then have more insured patients, less debt to spread around and the certainty that a certain revenue stream would be coming in. More of Senator Stanley's constituents would have access to health care when they need it. We would be delighted to work with him on Medicaid expansion. That's my answer."
After the heated back-and-forth, Minority Leader Richard L. Saslaw (D-Fairfax) seemed acknowledge that his vote against Stanley's bill had been "a political vote." Seeking to defuse the tension, he also suggested that the measure might be revived, perhaps as an amendment to another bill. A companion bill passed unanimously out of a bipartisan House committee earlier Tuesday.
"There's no such thing as a bill that's not amendable, not negotiable," Saslaw said. "There's always tomorrow."
Patrick County Hospital opened in 1962, after a three-year fundraising drive in which workers in local textile, tobacco and coal industries chipped in 75 cents to $1 a week. Run by the county for years, it was owned and operated by Pioneer Health Systems, which filed for bankruptcy in 2016. The hospital closed in September 2017.
Virginia Community Capital, public-private partnership that was the hospital's biggest creditor, bought the hospital at auction in December, the Enterprise reported at the time.
Stanley's bill would extend the state's certification of the hospital, which expired Dec. 31, for another year. He said the certification would make the property more attractive to purchasers. A new owner would still need to go through the federal certification process, but having the state certification remain in place could speed reopening by several months, he said.
Stanley's bill would pass in the Senate on a strict party-line vote, since Republicans control the chamber by a 21-to-19 majority. But he is also seeking an emergency clause to speed the measure to Northam's desk and allow it take effect immediately rather than on July 1, when most new laws kick in. He needed a supermajority of 32 senators — including Democrats — for that.
The 25-bed hospital serves a large swath of rural Virginia. With its closure, ambulances have had to travel as long as two hours to take patients to other hospitals, Stanley said.
Democrats say Medicaid expansion would provide health-care coverage to an estimated 400,000 uninsured Virginians and create 30,000 new jobs. Republicans opposed to expansion have questioned whether the federal government can afford to make good on its promise to pick up most of the tab, which in Virginia would amount to $2 billion a year.
Some House Republicans who opposed expansion under McAuliffe have signaled their willingness to expand health-care coverage in some form under Northam.
But there has been no obvious shift in the Senate, where just one Republican, Sen. Emmett Hanger (Augusta) has supported expansion in the past. Republicans control the Senate by the narrowest of margins — 21-to-19 — so if Hanger continues to support expansion, that would result in a 20-20 tie.
But Democrats would still need support from one more Republican, even though Lt. Gov. Justin Fairfax (D) breaks most tie votes. That's because expansion is part of the budget bill, and lieutenant governors are prohibited from voting on those.