Del. Ken Plum: The More Things Change, the More They Stay the Same

This is an opinion column by Del. Ken Plum (D), who represents Reston in Virginia’s House of Delegates. It does not reflect the opinion of Reston Now.

As the General Assembly heads back into Special Session on May 23 to continue work on the biennium budget impasse, I looked back at how long we’ve been fighting to expand Medicaid–the major sticking point in our current budget standoff. Here’s what I wrote in September 2014 — nearly four years ago!

Recently the New York Times editorial board wrote about the “health care showdown in Virginia.” Their comments were not favorable. “In Virginia, there are 400,000 low-income people who can’t afford health care coverage but don’t qualify for federal subsidies,” they wrote. “If they lived across the state line in Maryland, West Virginia or Kentucky, which have expanded their Medicaid programs, they could get the coverage they need.” The reason they cannot; “a group of recalcitrant Republicans in the House of Delegates” have blocked Medicaid expansion at every opportunity.

Highly regarded retired editorial writer for the Virginia Pilot, Margaret Edds, wrote about the current impasse in Virginia two weeks ago. Drawing on her extensive command of Virginia’s history, Edds points out that Virginia was the last state to join Social Security in the 1930s.
She argues that there is a moral imperative that “we cannot afford to take this risk” of not expanding Medicaid. She writes that “designing a health care system that embraces everyone is the right thing to do.” Reston resident, Elliot Wicks, in a recent letter to the editor makes the same argument that closing the coverage gap morally is the right thing to do.

In an unprecedented move, the Virginia Chapter of the American Association of Retired People (AARP) called a press conference to announce that letters sent by the Speaker of the House and other Republican lawmakers to their constituents over age 60 contained “inaccurate information about changes in Medicare.”
These letters from Speaker Howell and other lawmakers implied that expanding Medicaid in Virginia would hurt Medicare beneficiaries. “Expanding Medicaid to uninsured Virginians won’t harm the Medicare program or its beneficiaries,” the AARP spokesperson said.

Revenues for the Commonwealth are expected to fall short of projection for this year by as much as $300 million. Ironically, Virginia is losing $5 million a day amounting now to three-fourths of a billion dollars paid by Virginians that could be returned to the state through Medicaid expansion. The money could not be used to balance the budget in the current year, but in future years more than $200 million that Virginia pays for indigent care from its general tax revenue could be paid by Medicaid.

State and local chambers of commerce, medical and healthcare associations, and editorial boards of the major newspapers in the state have endorsed Medicaid expansion. A major compromise in the form of Marketplace Virginia, proposed by three Republican senators and endorsed by all Democratic legislators, has been introduced. The compromise proposed in Marketplace Virginia addresses the Republicans’ stated concerns by including a provision to discontinue the program if the federal government reneges on its commitments.

It is time for Republicans in the House of Delegates to agree to the compromise. Their insistence on separating Medicaid from the state budget is a costly stalling tactic that is hurting a large number of Virginians and threatens to hurt even more if the budget stalemate continues.

While the players have changed — it’s now Senate Republicans resisting Medicaid expansion — the song remains the same.