As the 2014 General Assembly session readied to adjourn, the House outlined a fiscally conservative, responsible budget that would provide critical funding for our teachers, schools, emergency personnel and local governments.
Yet, with a simple partisan vote in the Virginia Senate, the Commonwealth’s budget was taken hostage with no regard for reconciliation. In fact, Senate Democrats violated a compromise that resulted from the 2013 session — the Medicaid Innovation and Reform Commission (MIRC). The purpose of the MIRC was to allow the Commonwealth to undergo reform before discussing the expansion of the Medicaid system.
Making something better before making it bigger was once a common sense practice. Unfortunately this mantra has been cast out so that the governor can use the budget as a bargaining chip. Compromise is a two-way street. House and Senate Republicans have led the discussion on Medicaid and introduced the only substantive ideas for compromise.
However, every effort to reach an agreement has been rejected by Democrats: First it was disregarding the MIRC; then it was having a special session to focus on Medicaid separate from the budget. Further, House Republicans offered to extend the session 30 days and address Medicaid on its own merits. If these alternatives weren’t enough, one Republican senator even suggested what has become known as “Marketplace Virginia,” a private-exchange alternative.
It seems that all Democrats have been able to say is no. The “it’s my way or we’ll shut down the government” mentality is not the Virginia way and is not good government. By threatening to veto a budget and shut down the commonwealth, Gov. McAuliffe is setting a recklessly selfish precedent at the expense of all Virginians. Senate Democrats have been in lockstep with the governor by encouraging this impasse.
Marketplace Virginia, presented by Senator Watkins, did not pass from the Senate finance committee to the floor for debate; however, Senate Democrats were swift to inject some of their language into their budget, thereby creating an ill-defined demand for Medicaid expansion and violating the prior agreement that established the MIRC.
Excluding the language from Marketplace Virginia, the current difference between both the House and Senate budgets is only $26 million. In a budget that totals more than $90 billion, this is minuscule. However, the 29 lines of proposed code that were injected into the Senate budget pose a significant threat to the way in which the commonwealth functions.
Seventeen senators, 66 Republican delegates and one Democratic delegate have expressed serious reservations about the Marketplace Virginia language. On its face, the proposal is a vague, conceptual outline of a program that would create grave financial liabilities for the entire state. Passing this type of language is the equivalent of saying, “We need to pass it to see what is in it.” Virginia’s fiscal stability needs to be of the utmost importance; this “leap before you look” approach is irresponsible and could jeopardize the health, safety and welfare of millions of Virginians by placing the entire state in disarray.
There are serious issues with legislating the general concept of expansion without delving into the details of the program. By rushing in blind, the General Assembly would welcome a number of unintended consequences that could reasonably be avoided by discussing Medicaid proposals based on their merit. By not thoroughly examining these issues, we would be unable to consider the actual cost to administer the program’s expansion.
For example, the Department of Social Services shares personnel between the state and our localities. Our current system has difficulty fulfilling entitlements as is. Expanding the number of entitlements without first ensuring we have the appropriate mechanisms to do so would be disastrous. Localities would be forced to invest in an inadequate system and raise taxes to do so. Ultimately, this would create additional strain on localities and increase the number of individuals who do not receive the entitlements to which they have been promised.
Fauquier County is currently in the process of appropriating a budget under heightened demand to fund essential services such as emergency personnel and schools. By forcing the county to pay for even more administrative staff, Medicaid expansion would impose an unfunded mandate upon the county. Further, the implementation of Marketplace Virginia would create regulatory issues since it departs from traditional Medicaid reimbursement rates.
As opposed to the typical 70 cents on the dollar reimbursement provided by Medicaid, Marketplace Virginia would rely on private insurers and could be subject to significantly higher rates. It should also be noted that the federal government has not approved waivers for this type of program.
Medicaid expansion must be separated from the budget; it must be properly vetted. We have seen the disastrous effects of the Affordable Care Act, many of which could have been avoided by practicing good government. We must take a responsible, measured approach to the future of the Commonwealth. We must provide suitable funding to our localities, public safety folks and schools as opposed to demanding taxes be levied to fund the expansion of an inadequate Medicaid program.
It is my firm belief that we must decouple Medicaid from the budget, evaluate it on its own merits in special session and pass the budget now.
Del. Michael Webert
Representative, 18th district