Last week Democrats in the House of Delegates were able largely to sit on the sidelines as Republicans debated among themselves whether Virginia should expand access to medical care through the federal Medicaid program. Arguments that had been used by Democrats to support Medicaid in the past were now being used by Republicans to support their newly found support for expansion.
The news is good since Medicaid expansion could only come about with bipartisan support. When the final vote was taken on the issue, only 31 Republicans voted “nay” and all Democrats voting “aye” with 20 Republicans making the total for passage 69 votes. There was a sense of relief as a goal for which we had been working for more than a half dozen years moved closer to realization.
The news was not so good on the other side of the Capitol. The Senate passed a budget that did not include further Medicaid expansion. While there was an effort to amend the Senate bill to include the expansion of access to health care, it failed along a straight party line vote. Final passage of a budget for the next two years requires that the bills passed in each house be identical. A conference committee made up of House and Senate members must resolve the largest imbalance in the budget that I have ever seen before its final adoption.
If I had predicted before the session where we would be at this point I would have said that the Senate would have passed a version of Medicaid expansion but the Republicans in the House were maintaining their opposition. At least that’s what the public pronouncements and the rumor mill suggested.
How could we have been so wrong? I believe that the predictions on the outcome of the session left out one very important consideration: the results of the 2016 elections. The House’s 66 to 34 Republican control was diminished to a close margin of 51 to 49. For weeks it appeared that Democrats might take control. Among the losses were senior members and committee chairs who were opponents of Medicaid expansion and were expected to win re-election easily. The Speaker who opposed expansion retired.
The voters in 2016 sent a clear message that they supported Medicaid expansion. For most it simply did not make sense to leave more than ten billion federal dollars on the table when there were so many people without access to health care. Many more people went to the polls than usual to send the message to legislators. Whether it was public opinion polling or common sense that showed the Republican majority they were in trouble and needed to change the stance on issues, the public speaking through the ballot box brought about this very important change for Virginia.
How to explain the Senate vote? Senators with four-year terms have not been before the voters since 2014. They have not had a recent message from the electorate and could be in for a big surprise if they do not re-evaluate their positions. The real heroes in all this are the Indivisibles and other groups that mobilized voters in 2016 to elect responsive candidates. These new members are bringing balance to public policy as well as to the budget.