Tomorrow, the Assembly will re-assemble for a special session on Medicaid expansion. This special session was promised back in June 2014, when the Senate — under new ownership — jettisoned “Marketplace Virginia” and, instead, adopted the House Budget.
At that time, we were told that we “needed” a special session to examine all aspects of Medicaid reform prior to debating expansion. Or maybe we needed another reason to sit around for two days and get nothing done, except (perhaps) electing some new judges.
Actually, there was a moment when Medicaid expansion in Virginia could have been done quickly and with a minimum of fuss. It was February 2013. But the Democrats missed that opportunity. Here’s how it went down …
When the Assembly convened in January 2013, the times were different. Obama had been re-elected. McDonnell was Governor and had robust approval ratings. RGIII was the Rookie of the Year and the toast of the town. It was (comparatively anyway) “the Era of Good Feelings” in the Commonwealth.
In early February, the “Republican-controlled” Senate took up its amendments to the biennial budget, including the issue of Medicaid eligibility, which had been passed to us by the U.S. Supreme Court. By a vote of 36-4, we passed an amended Senate budget that included full expansion of Medicaid with Federal funding.
While there was some pro forma opposition, it was generally viewed that Medicaid expansion, with Federal support, was inevitable. Indeed, it made no sense to say “no.”
A few weeks later, the Medicaid expansion was hung up in the House, which wanted to attach all sorts of conditions, including the dreaded “MIRC” commission. Meanwhile, Governor McDonnell’s “landmark” transportation plan was in a Republican-controlled conference committee and needed Democratic votes to pass.
Do you see where I’m going with this?
Over the next few days, there were multiple conversations about “horse trading” votes for the transportation plan (which McDonnell wanted) against votes for Medicaid expansion (which he had not publicly opposed but was ambivalent). But the correlation was merely hypothetical at that point. Nobody knew details.
A couple days later, the Republican conferees voted out the revised transportation bill which included the “hybrid tax,” a new sales tax targeted for NOVA, and a reduction in the gas tax. (No, it made no sense in 2013 either). A lot of Democrats like me hated the concept — but most felt constrained to support it.
To me, the vote swap was obvious. Governor McDonnell was on full court press to pass his signature bill. The budget bill was still in conference but within the Speaker’s control. And he was 100% backing the Governor.
There were a number of conversations, both in public and behind closed doors. Without going into detail, a few people — including me — felt strongly that Democrats should not commit to a dysfunctional transportation bill until there was agreement on Medicaid.
Unfortunately, that bluff was called as the Republicans passed the transportation bill easily in both bodies, without giving an inch on Medicaid expansion. (FWIW, I voted “no” on McDonnell’s bill but for my own substantive reasons).
Later that evening, the Senate adjourned having passed a budget which made no accommodation on Medicaid and simply punted the issue to 2014. And we all know how that’s ending up. The sum total will cost billions of dollars to Virginia and deprive approx 400,000 Virginians of health care coverage.
Anyway, the readers can draw their own conclusions about what we accomplished (or didn’t) in the 2013 session. To many Senators, it was worth going forward on the Governor’s transportation bill because that was our only chance for those funds. In time, that may be proved correct. But we can hardly state that we “never” had a chance to pass Medicaid expansion in Virginia.