Peter’s Take: McAuliffe Is Right on Virginia Medicaid Expansion

Peter’s Take is a weekly opinion column. The views and opinions expressed in this column are those of the author and do not necessarily reflect the views of ARLnow.com.

On March 27, Virginia’s Democratic Governor Terry McAuliffe announced that he was renewing his call for Virginia to expand Medicaid under the Affordable Care Act:

“The state is losing out on $6.6 million a day in federal money by not expanding Medicaid eligibility to roughly 400,000 low-income adults. McAuliffe has proposed a budget amendment that would give him power to expand Medicaid, saying the issue had gained new urgency after Trump’s defeat … in repealing the Affordable Care Act.”

The Virginia Republican legislative leadership quickly replied:

“They said they would reject McAuliffe’s proposed budget amendment when the General Assembly returns to Richmond in April.”

Discussion

Terry McAuliffe is right that Medicaid should be expanded. Virginia Republican legislative leaders should work with him to find a bipartisan solution.

Under the ACA, states can choose whether to expand Medicaid to cover people making up to 138 percent of the federal poverty level, or about $16,640 for an individual. The federal government currently picks up almost all the cost, although that percentage is scheduled to decline to a 90 percent federal share by 2020. About half of the 31 states that have chosen the Medicaid expansion have Republican governors.

One of those Republican governors is John Kasich of Ohio. Kasich has forcefully criticized Donald Trump’s failed efforts to gut the Medicaid expansion program:

That is a very, very bad idea, because we cannot turn our back on the most vulnerable. We can give them the coverage, reform the program, save some money, and make sure that we live in a country where people are going to say, ‘at least somebody’s looking out for me,'” he said. “It’s not a giveaway program — it’s one that addresses the basic needs of people in our country.

Michigan’s Republican Governor Rick Snyder agreed, touting “Michigan’s embrace of the Medicaid expansion, which has covered 642,000 people in the state.”

Virginia’s Republican legislative leaders can pick and choose from a whole host of Medicaid expansion options pioneered by Republican leaders in other states. Besides Ohio and Michigan, Virginia’s Republican leaders can look to other states like Arkansas or Pennsylvania.

So far, Virginia’s Republican leaders have offered a variety of excuses for not following the example set by Republican leaders in any of these other states. They have argued that Virginia cannot afford the 10 percent share of the costs that the federal government ultimately will not cover. But, Virginia’s hospitals have offered to cover the state’s share.

Virginia Republicans also have argued, and continue to argue, that the ACA is going to be repealed. Why risk expanding Medicaid under the ACA, and then have the coverage taken away? But Republicans like Kasich and Snyder have had the courage to fight successfully for their covered residents.

Finally, Virginia Republicans have argued that there is fraud and abuse in Virginia’s existing Medicaid program. While it is true that some fraud and abuse has been identified, there is a detailed roadmap for fixing the problems. There is no reason not to simultaneously implement the identified safeguards and expand Medicaid.

Conclusion

Regardless of what happens with Gov. McAuliffe’s latest budget amendment, Virginia Republican and Democratic leaders should work together to reach a bipartisan solution to expand Medicaid. It’s the right thing to do. The benefits substantially outweigh the costs.