IN THE course of Virginia’s long debate over expanding Medicaid to extend health coverage to hundreds of thousands of poor people, Republicans in Richmond have budged not an inch from their blanket opposition. They have been unmoved by logic, by public opinion and by economics. They have ignored the shifting attitudes of GOP governors and lawmakers in other states. They have disregarded the pleas of Virginia business leaders and hospital executives. They have even thumbed their noses at the handful of moderates in their own ranks who have suggested compromises.
The opposition of Virginia’s GOP lawmakers to any form of Medicaid expansion — under any conditions or timetable or permutation — has assumed its own convoluted logic. They are against using federal funds to insure poor Virginians mainly because the other side — namely, President Obama — is for it.
The blatant bankruptcy of the Republican position was on display in Richmond this week, where legislators met in special session to debate the Medicaid expansion — despite the fact that the GOP-controlled House of Delegates had dug in its heels, making a charade of the entire exercise.
The core argument of Republican lawmakers in the House of Delegates and their leader, Speaker William J. Howell (Stafford), is that Virginia cannot risk getting stuck holding the bag if the federal government reneges on its promise to pay for 90 percent of the proposed expansion (after picking up 100 percent of the cost in the first two years).
That argument has been exposed as phony — ironically, by one of the GOP’s tiny handful of moderate lawmakers, Del. Thomas Davis Rust of Fairfax. Mr. Rust, seeking to break the impasse between Gov. Terry McAuliffe (D) and his Republican brethren, proposed pulling the plug on any expansion in the event federal funding disappeared.
Mr. McAuliffe and other key Democrats indicated they would support that compromise — or, for that matter, virtually any compromise. But even though it addressed the GOP’s main stated objection head-on, the reaction of Republicans was resounding hostility.
Naturally, neither Mr. Howell nor any other conservative Republicans have ideas for how to extend health coverage to the 1 in 8 Virginians who lack it — nearly a million people in total. They have advanced no legislation, nor even the seed of an idea, that would provide a basic safety net for their low-income constituents who must deal with their health problems by visiting emergency rooms. That is a costly and inefficient means of providing health care, but Mr. Howell and his caucus are dead-set on preserving it.
By expanding Medicaid under Obamacare, Virginia would gain access to some $2 billion in federal funds annually, creating an estimated 30,000 jobs. It would revive hospitals that are struggling with the new federal rules and provide health insurance to more than 350,000 people who are currently uncovered.
Republican governors and lawmakers in a half-dozen states have seen the sense in going ahead with some version of Medicaid expansion. But in Virginia, the Republican theology of massive resistance has trumped the logic of good policy.