RICHMOND — Gov. Terry McAuliffe will make a renewed push to expand Medicaid under the Affordable Care Act this week when he presents legislators with a budget plan that calls for extending the government health-care program to 400,000 uninsured Virginians.
The planned announcement is widely seen as symbolic given fierce opposition to expansion in the GOP-dominated House. But the move has raised Republican hackles if not hopes among expansion advocates, setting the stage for more partisan warfare in a Capitol where a more collegial “Virginia way” once held sway.
McAuliffe (D) devoted much of his first year in office to his chief campaign promise, first by trying to woo House Republicans, then by seeking to find a way around the General Assembly. Failing on both fronts, he seemed to turn his focus to job creation.
But this month, McAuliffe’s health secretary indicated that the governor was gearing up for Round 2. Health and Human Resources Secretary William A. Hazel Jr. told reporters that he expected Medicaid to be “a big topic again” in the legislative session that begins in January.
Few people expect McAuliffe to devote as much political capital and energy to this second push as he did to the first. But keeping the issue alive could win him points with his liberal base, as will other seemingly quixotic battles, such as trying to persuade the Republican-controlled General Assembly to tighten restrictions on guns.
“I think he’s a realist on it,” said former Virginia Commonwealth University political scientist Bob Holsworth. “I think he wants to make a statement.”
McAuliffe will present a plan to expand Medicaid on Wednesday morning, when he proposes amendments to the current two-year budget to House and Senate money committees. His proposal, first reported by the Associated Press, projects that the program would generate savings of $100 million in 2016. But it sets that money aside for future use instead tapping it to help the state close a $322 million shortfall.
McAuliffe spokesman Brian Coy declined to discuss the Medicaid plan, except to say, “I will not dispute” the AP article, which was based on unidentified sources.
“The governor has been pretty clear that he believes this is a moral, fiscal and economic imperative,” Coy said.
House Majority Leader M. Kirkland Cox (R-Colonial Heights) said he was “very disappointed” to hear that the governor would include Medicaid expansion in the budget amendments given that the House voted overwhelmingly three times this year to reject expansion.
Reviving the Medicaid issue will only make it harder to find common ground on areas where bipartisan agreement is possible, such as job creation and veterans affairs, Cox said.
“It doesn’t help, to be blunt,” Cox said. “That issue was very divisive last year.”
McAuliffe and a slim bipartisan coalition in the state Senate have supported expansion under President Obama’s signature health-reform law. They say it would provide needy Virginians with health care, help hospitals hurt by Affordable Care Act cuts and create more than 30,000 jobs.
House Republicans are staunchly opposed to extending an entitlement program to able-bodied adults. They also doubt the federal government can afford to bankroll most of the $2 billion-a-year cost.
Critics of expansion noted that the budget plan sets aside the projected $100 million in Medicaid savings, seeing it as evidence that even McAuliffe knows expansion will not happen.
“I think that speaks volumes as to what the governor’s expectations and his purpose” are, said Sen. Mark D. Obenshain (R-Harrisonburg).
Some Democrats gave McAuliffe credit for not giving up.
“It’s worth trying,” said Senate Minority Leader Richard L. Saslaw (D-Fairfax).
Said Sen. Janet D. Howell (D-Fairfax): “It’s the time of year when miracles happen.”
But even some advocates for expansion conceded that the expansion plan was not likely to go anywhere.
Sen. John C. Watkins (Powhatan) is one of three moderate Senate Republicans who this year supported a form of expansion that would have used the federal money to buy private insurance for enrollees. Coy declined to say whether McAuliffe would propose that sort of “private-option plan” or more conventional Medicaid expansion.
But either way, Watkins doubted McAuliffe would win.
“He’s trying to pick as many fights as he can,” Watkins said, also noting McAuliffe’s announcement on gun restrictions. “He’s going to hit all the issues, I guess.”