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GOP legislators adamant on Medicaid, budget split

Sunday, March 23, 2014

By DEBBIE HALL - Bulletin Staff Writer

Many GOP lawmakers are heading back to Richmond for Monday’s start of a special General Assembly session that they hope will end with a state budget — minus a Medicaid expansion provision.

“My goal is to pass a budget and then get the governor to call us in for a special session” to discuss the Medicaid issue, said Del. Danny Marshall, R-Danville.

Gov. Terry McAuliffe supports expanding Medicaid. His campaign platform for last November’s election stated that an expansion would create more than 30,000 jobs, provide coverage to an estimated 400,000 people and save money as Virginia transitions toward more home-and community-based care.

For the first three years of an expansion in the program, the government would fund 100 percent of the expansion as part of the Affordable Care Act.

“And they have promised to cover up to 90 percent for the next two years. Not at least 90 percent, but up to” that amount, said state Sen. Bill Stanley, R-Glade Hill.

“After that, all bets are off” as to what, if any, amount the federal government would pay, Stanley said.

GOP lawmakers have said they doubt the federal government’s ability to continue paying those costs, disagree with an expansion being tied to the budget bill, and believe the current system needs a thorough review before an expansion is broached.

State Sens. Dick Saslaw, D–Fairfax, the majority leader, and Donald McEachin, D–Henrico, the Senate Democratic Caucus chair, said that in the Senate, “a bipartisan majority is ready and willing to close the coverage gap.”

But Marshall said he is firm in his belief that Medicaid is a complex issue that should be discussed in a special session.

“We are asking to separate the two issues and then have a special session on Medicaid. It’s a big, big issue” and will have continued costs to state taxpayers, he added.

Currently, about 22 cents of each tax dollar goes to Medicaid costs, Marshall said. “It is the fastest growing line item today.”

Public opinion also seems to be divided, according to Marshall. “I’ve heard from (people on) both sides of the fence,” he added.

Del. Les Adams, R-Chatham, said he has tried to get as much input as possible from constituents, and “the overwhelming majority is consistent with our position” that Medicaid expansion and the budget are separate issues.

Officials in several localities, including Pittsylvania County, have passed resolutions calling on the state legislature to sever the two issues, Adams said. A consensus to that effect also was conveyed during a recent meeting with some Henry County officials, he added.

As a result of the input he has received, Adams said he has not changed his mind.

“It’s not that I don’t appreciate the real challenge that a lot of folks have in this area, because I do. I totally agree the cost of health care, and the cost to insure, is out of control,” he said. “The price does not seem to be reflective of the market demand, and I do recognize that as a problem.”

However, he said he is “convinced the effort to expand Medicaid” under the current circumstances is not prudent for Virginia.

Stanley said he has spent the last few weeks touring the district and talking to constituents about Medicaid expansion. “I have checked my emails vigilantly, and I’ve found that the majority of the people I’ve talked to do not favor Medicaid expansion,” he said.

He also has received phone calls about the subject, mostly from people “who just say ‘Stand firm,’” Stanley said. “I did get one call from someone who was for Medicaid expansion, and that person was from North Carolina.”

Marshall said most of the people who have expressed support of an expansion “have either been health care professionals or people who do not have health care (insurance). There are also a lot of people who have called me and said we shouldn’t do it. It just depends on who you listen to. Certainly, if you listen to the hospitals, they say we want this, and I certainly understand.”

That is because the Affordable Care Act (Obamacare) cut some Medicare spending, which will impact hospitals, officials have said.

Marshall said the proposed state budget already includes additional funds — basically “the money doubles” — to free clinics. An additional estimated $400 million per year is proposed to go to hospitals in each of the two-year budgets, he said.

Former Gov. Bob McDonnell created a task force last year to study the Medicaid issue and consider a potential expansion after first identifying and then finding ways to remove fraud and abuse, Marshall said.

“But to me, that’s still a separate issue. I think the number one issue right now is to pass the budget,” Marshall said.

He added that McAuliffe has indicated the special session will last about three days. “... But I don’t know how many pairs of socks to take with me,” Marshall quipped.

Del. Charles Poindexter, R-Glade Hill has had similar experiences.

Alex Thorup, legislative aide for Poindexter, said “all the phone calls we get have been people encouraging us to stand up to McAuliffe.”

The governor “said he wanted everybody to go home and hear from their constituents about why we need to expand,” but Poindexter has not had those responses, Thorup said.

Contacts he has had are “from people who seem to be pretty educated about the issue. They know the current system is broken, how much it is costing now, and they are worried about” the federal government’s ability to continue to pay 90 percent of the expansion cost after the first three years, Thorup said.

“Quite honestly, I didn’t really expect this, but it’s nice to have that support,” he added.


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