Virginia Lawmakers Reject Medicaid Expansion as Congress Stalls

Published May 18, 2017

Virginia state lawmakers rejected a budget amendment proposed by Gov. Terry McAuliffe (D) that would have expanded Medicaid days after congressional Republicans canceled a vote to replace the Affordable Care Act (ACA).

In a party-line vote, Virginia House Republicans rejected McAuliffe’s Medicaid expansion proposal 66 to 35 on April 5. McAuliffe had offered the budget amendment on March 27, the Monday after U.S. House Speaker Paul Ryan (R-WI) pronounced Obamacare “the law of the land” because the now-obsolete version of the GOP-backed American Health Care Act (AHCA) lacked adequate support.

“In light of President Trump’s failed attempt to repeal the Affordable Care Act, the Commonwealth has no excuses left to hold out on Medicaid expansion,” McAuliffe stated in a press release after the Virginia House vote. “By refusing to expand the program, we’ve forfeited $10.4 billion and we will continue to forego $6.6 million every day we do not take action.”

Expanding Medicaid would have given taxpayer-funded health insurance to almost 400,000 Virginians earning up to 138 percent of the federal poverty level, or $33,600 for a family of four, according to McAuliffe’s statement.

Medicaid vs. Health

Caleb Taylor, director of policy and operations at the Virginia Institute for Public Policy, says McAuliffe has mistaken Medicaid expansion for access to good health care.

“The governor’s persistent conflation of Medicaid expansion and the ‘health of the people’ is interesting,” Taylor said. “There has been little to no evidence that Medicaid expansion equates to the expansion of good health. We do not always see eye to eye with the Republicans up at the statehouse, but this time they were absolutely spot-on.”

The public is not getting its money’s worth from the nation’s government-heavy health care system, Taylor says.

“The U.S. spends a much larger amount on health care, both public and private, than most everywhere else on the planet, but we do not receive a correlative increase in general health,” Taylor says. “Virginia is no different. Even without the expansion, Virginia spends more on public health care than we do on K–12 education.”

Waiting on U.S. Senate

Michael Thompson, chairman and president of the Thomas Jefferson Institute for Public Policy, says Virginia lawmakers recognize Medicaid expansion as an unnecessary expense.

“The General Assembly refused to expand Medicaid once again, just as it has done for the previous budgets under Gov. McAuliffe,” Thompson said. “The reasoning was Medicaid already takes 22 percent of the state budget and is growing each year. Those not covered are mostly healthy lower-income folks.”

Expanding Medicaid under ACA could further damage Virginia’s health care economy if Congress and President Donald Trump replace Obamacare, Thompson says.

“Until the Congress decides on a reform to the current national health care system, the Virginia House of Delegates thought it was unreasonable to move into new territory without knowing what the future regulations, requirements, and mandates might be once Obamacare is scuttled,” Thompson said.

The U.S. House of Representatives passed a version of AHCA on May 4. The bill is under consideration in the Senate.

Michael McGrady ([email protected]) writes from Colorado Springs, Colorado.