As a gubernatorial candidate in 2013, Virginia's Terry McAuliffe (D) made Medicaid expansion a key plank in his statewide platform. After the election, however, Republicans in the state legislature didn't care and killed the proposal.
A year later, the determined governor launched an effort to circumvent state lawmakers and adopt the policy over GOP objections. That didn't work, either.
But McAuliffe is nothing if not determined. The Washington Post reported the other day on the Democratic governor's latest idea.
Gov. Terry McAuliffe intends to make another push for Medicaid expansion despite intense opposition from Republicans, who retained full control of the General Assembly in elections last week. McAuliffe (D) said he will pursue a new strategy that he thinks will be more palatable to conservatives -- one that he said would allow Virginia to extend health-care benefits to 400,000 uninsured citizens at no cost to the state. Previous plans have called for Virginia to eventually pay 10 percent of the annual $2.4 billion cost, which amounts to $240 million.
Under Medicaid expansion through the Affordable Care Act, federal funds initially cover 100% of state costs, though eventually the federal contribution drops to 90%. It's still an amazing deal, which 30 states -- "blue" and "red" -- have eagerly taken advantage of, not only to help low-income families, but also to bolster state hospitals and improve state finances.
Virginia Republicans have nevertheless refused, some citing the 10% commitment in the future. McAuliffe said late last week, however, that he envisions a $0 price tag. “I do believe we will be able to present this in a fashion with zero obligation to the state,” he said in an off-the-cuff comment to reporters.
The governor has not yet gone into any details, but one of the ideas that's been kicked around is forcing state hospitals, which stand to benefit tremendously from Medicaid expansion, to cover the difference. "[H]ospitals clearly want this money," the governor said on Friday, adding, "For every dollar they put in, they get a multiple back.”
If this at all sounds familiar, Indiana embraced Medicaid expansion through a similar model.
The question would then become very different: would Virginia Republicans block Medicaid expansion even if it didn't cost the state any money at all?
That remains to be seen, though I hope Slate's Dahlia Lithwick won't mind if I again quote her terrific piece on this from last year, when she explained how "pissed" she was about GOP state lawmakers' refusal to act responsibly.
The Commonwealth of Virginia is modeling dysfunction yet again this month, as the legislature fights to the death over Gov. Terry McAuliffe’s proposed two-year, $97 billion budget. The government is imploding in large part due to the fact that state Republicans in the House of Delegates have decided to fight tooth and nail – up to and including shutting down the whole government if this is not resolved by July – to avoid expanding Medicaid benefits to cover up to 400,000 lower-income Virginians who fall into the health care coverage gap. [...]As with all government shutdowns, the answer to “why is this happening?” is “Republicans hate Obamacare.”
Dahlia added that “the sheer nihilism on display in Richmond shows what happens when you convince yourself that government can fix nothing.”
Perhaps the posture will change when the cost is nothing?