REPUBLICANS IN Virginia’s House of Delegates are running out of excuses to refuse a huge pot of federal money for expanding health-care coverage to poor people. The legislature this week convened a special session, the product of House Republicans’ baseless refusal to compromise on the health-care expansion. Both Virginia Gov. Terry McAuliffe (D) and the state Senate have offered compromise plans, responding to the House GOP’s proffered reasons for opposition with more seriousness than they deserve. If the Republicans’ opposition is anything beyond thoughtless or cynical, they should come to the negotiating table now.
The special session was called to agree on next year’s budget. But the battle is over one piece of the state’s financial plan: whether to accept federal funds to expand eligibility for Medicaid, the federal-state partnership that offers health-care coverage to people below and around the poverty line. The Affordable Care Act’s coverage plan depends on this expansion, but the Supreme Court ruled that states could opt out. Virginia is one of those that hasn’t made up its mind, even though the federal government has committed to pay nearly the whole tab, in perpetuity, with tax dollars it is already collecting from every state, including Virginia, whether they expand or not.
Rather than accepting the federal offer and moving on, House Republicans attacked the design of the Medicaid program, insisting that it was too broken for them to expand it in good conscience. Senate moderates responded with a proposed expansion outside of the traditional Medicaid system, offering to use federal cash to buy people private coverage instead. The governor endorsed the idea. The House didn’t budge.
House Republicans then claimed that, even if the expansion were designed more to their liking, they couldn’t count on the federal government to hold up its end of the funding bargain. That argument has never made much sense: The state routinely accepts federal dollars on less generous terms without similar hand-wringing, and the legislature would be able to roll back the program if the feds pulled back on the funding. Nevertheless, Mr. McAuliffe answered that objection Monday by offering an explicitly temporary, two-year expansion of the Medicaid program in Virginia. The House hastily rejected this compromise offer in a committee vote.
House Republicans now insist that the Medicaid fight shouldn’t be part of the budget process. Pass a budget first, they say, then talk about expanding coverage. That argument fails to account for the fact that the governor wants to fund various measures with budget savings projected from the inflow of federal Medicaid dollars. It also amounts to a demand that those in favor of expansion surrender all of their leverage, which would be a lot more credible if House Republicans showed any interest in sorting out the Medicaid issue in good faith. Rather, their latest fall-back excuse seems to be more of the same: a desperate, trumped-up objection that exposes how weak their substantive case really is.