Columnist

Watch this, America. A state may be about to do something sensible, bipartisan and even humanitarian to take care of its people.

It could still fall apart, as it has before. But Virginia’s lawmakers appear to be on the verge of insuring about 400,000 low-income residents by expanding Medicaid after years of refusing to do so.

Remember, Virginia is a place where thousands of people queue up before dawn on one weekend every summer to get free treatment from volunteers who turn livestock pens into medical crash units at the Wise County Fairgrounds because people are so desperate for care.

It’s a scene I visited four years ago when the Remote Area Medical clinic was the only hope for folks with bleeding gums, black lungs, oxygen tanks and broken backs to get treatment.

The rural county still hosts this clinic every year, and what unfolds looks like refugee camps in war-ravaged countries. At midnight before the clinic opened that year, 1,204 people were already in line. And it wouldn’t have been necessary if the commonwealth had expanded access to the federal health-care program for the poor.


In 2014, Molly Bass, 3, waited in the car for 15 hours because her dad, Tim Bass, needed some dental work done and couldn’t afford it. (Michael S. Williamson/The Washington Post)

The whole issue of Medicaid expansion is long overdue in Virginia.

Four years ago, when the legislature was close to a Medicaid expansion, state Sen. Phillip P. Puckett (D-Russell) pulled the plug on the whole thing by resigning, tipping the balance in favor of the Republicans who had been fighting it.

(A federal investigation into why Puckett suddenly left with a cushy job offer in the tobacco world waiting for him — a job he did not take — was dropped and yielded no charges.)

This time around, the guy about to change the debate is a Republican breaking with his party: state Sen. Frank W. Wagner (Virginia Beach).

Wagner told The Washington Post’s Laura Vozzella last week that he’ll support allowing more of his state’s low-income residents access to health care as long as a rise in personal income doesn’t knock them out of the coverage bracket and the state offers some kind of help to middle-class families that have insurance but are having a tough time making those rising co-pays and premiums.

If the special budget session convening in Richmond on Wednesday moves forward on expansion, Virginia would join 33 other states that have made this move, according to the Henry J. Kaiser Family Foundation tracker on the topic. Utah is also considering a version of expansion.

It’s unbelievable that this has been such a long, tough fight.

The 400,000 or so Virginians who would be helped are people who should receive federal assistance. In a Medicaid expansion, the feds would pick up 90 percent of the state’s health-care tab — about $2 billion annually. Right now, the state goes 50-50 on all Medicaid expenses. But Republicans are suspicious that the federal subsidies would disappear down the road and that the state would be stuck with the bill.

Okay, but expanding Medicaid supports the state’s small businesses and helps ensure a healthy workforce.

Many of the folks I met that dark morning at the mobile health clinic had part-time jobs, so they didn’t qualify for health-care benefits, even if they worked for an employer that provided them.

Virginia is talking about tying Medicaid benefits to a work requirement, fueling the cynical narrative that there must be all kinds of folks lazing around on couches, asking taxpayers to pay their bills.

Wrong. Eighty percent of non-disabled adults with Medicaid coverage are part of working families, according to the Healthcare for All Virginians Coalition.

And when people are healthy, when they can go to a doctor and get treatment for illness, diseases, addiction and mental health problems, they’re more able and likely to get work. No brainer. (Except there’s the issue of child care, but that’s a different fight.)

Health care for a healthy Virginia was a fight that Gov. Terry McAuliffe (D) didn’t win. It was waged in the middle of an Obamacare smear campaign that made the health of millions of Americans a partisan, political football.

It would be a great political win for newly elected Gov. Ralph Northam (D), sure. And a symbolic one for a governor who is also a pediatric neurologist and former Army doctor.

But it’s also a chance for Virginia’s lawmakers — from both parties — to do the right thing. Finally.

Twitter: @petulad