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Why Northam and Warner went to a school to talk about health care

Virginia Gov. Ralph Northam (D) has been trying to rally support for expanding Medicaid eligibility.
Virginia Gov. Ralph Northam (D) has been trying to rally support for expanding Medicaid eligibility. (Bob Brown/AP)

RICHMOND — Gov. Ralph Northam’s Medicaid expansion push took him to a city middle school Thursday as he sat down with Sen. Mark R. Warner to make his pitch to teachers, administrators and parents.

If a school seemed like an odd venue for a health-care discussion, that was quickly cleared up. The governor and former governor, both Democrats, said Virginia would have more money for K-12 education and many other priorities if the state expands its Medicaid program under the Affordable Care Act.

That’s because the federal government would pick up certain health-care costs the state now pays, freeing up $421 million over two years that could be spent elsewhere, as Northam has proposed in his biennial budget.

“That difference, just expanding versus not expanding, is $421 million,” Northam said. “So when you talk about what we could do with $421 million, we could use it for higher education. We could use it for K-12. We could give our teachers raises. We could give our law enforcement raises.”

Northam has crisscrossed the state this week, trying to rally support for adding as many as 400,000 uninsured, low-income Virginians to the federal-state health-care program. His schedule looked more like a goodwill tour than an explicit push for expansion, with events that had no obvious connection to Medicaid.

But it was strategic hopscotching — to the districts of Republican senators he is trying to woo ahead of a special General Assembly session that begins April 11.

Northam threatens (nicely) to use amendment to muscle in Medicaid

During this year’s regular session, the Republican-led House approved an expansion measure, but the Republican-led Senate did not. The standoff kept legislators from passing a budget before adjourning March 10. Northam has called them back for the special session to continue working on a budget, which must be completed by July 1 to avoid a government shutdown.

On Monday, Northam flew to the University of Virginia’s campus in Wise County to learn about the institution — and rub elbows with Sens. Ben Chafin (R-Russell) and Charles W. “Bill” Carrico Sr. (R-Grayson).

He heads back to the southwest again Friday to formally sign a bill, sponsored by Chafin in the Senate, related to newborn health screenings.

In between came the visit Thursday to Richmond’s Albert Hill Middle School, which is in Sen. Glen H. Sturtevant Jr.’s district.

“We want to make sure that he gets our attention,” Northam said when asked whether he had chosen the location with Sturtevant in mind.

Sturtevant (R-Richmond), a former school board member, did not attend. He did not immediately respond to a request for comment.

Under the ACA, the federal government will pick up 90 percent of the cost of expansion, which in Virginia would amount to $2 billion a year. Under Northam’s plan, a tax on hospitals would cover the state’s 10 percent. Republicans who oppose expansion have said they fear that Washington will not keep its funding promise, sticking Virginia with the full tab and imperiling funding for schools and other priorities.

“The budget approved by the Senate commits substantial additional funding to both K-12 and higher education,” said Sen. Ryan T. McDougle (R-Hanover), chairman of the Senate Republican Caucus. “Governor Northam’s insistence to use the budget to impose Obamacare’s Medicaid expansion is not fiscally responsible. Instead of beginning his term with a budget impasse that could lead to a government shutdown, he should approve a budget based on existing revenues, as the Senate has done.”

Warner said that so many states have expanded that he is confident that Congress will never do away with the funding.

“I believe with all my heart . . . the federal government’s going to honor this commitment,” he said.

Republican Medicaid expanders in Va. say backlash is milder than expected

Some legislators who support expansion take exception to using the savings for purposes not related to health care, most notably Sen. Emmett W. Hanger (R-Augusta), the lone Senate Republican who has supported expansion in some form. Hanger has said he wants any savings to be used to bring down the cost of health care, not to fund other areas of the budget.

At the meeting in the school library, Northam urged about 20 parents and school staff to let their legislators know that they support expansion because of the money it could mean for schools.

The resources are needed, the crowd seemed to agree. A mother spoke of the need to beef up school security, given recent school shootings. Teachers said their schools lack full-time nurses and counselors. While Northam touted a 2 percent raise for teachers, who are paid $7,500 less than the national average, one teacher said he would rather have the money go to fund support staff who make the job more manageable.

Richmond public schools would receive $2.6 million out of the $421 million in projected Medicaid savings under Northam’s plan. One teacher wondered how far that amount could really go when spread across the city’s 40-plus schools, some of them in “dire” physical shape.

Warner, referring to himself as a “budget nerdy guy,” said the money could be “put aside to fund a bond effort to do improvements. You’ve got to have that ongoing revenue to pay down the capital that you borrow.”

Still, Northam acknowledged that Medicaid expansion could not do it all. “This is not the ultimate remedy for K-12 public education,” he said. “The discussion doesn’t stop after that.”