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“I believe it’s time to start to look at alternatives to expansion,” state Sen. Walter Stosch said.
Tuesday, October 15, 2013
A pivotal state legislator in the debate over expanding Virginia’s Medicaid program wants to examine alternatives for providing health care through the private market.
Sen. Walter Stosch, R-Henrico County, chairman of the Senate Finance Committee, said last week that he wants to consider approaches used by other states in the face of political opposition to extending Medicaid coverage to childless adults, parents and others below or barely above the poverty line.
“I believe it’s time to start to look at alternatives to expansion,” he said, citing market-based approaches in states such as Iowa and Arkansas to take advantage of billions of dollars in federal spending without expanding the program for the poor, elderly and disabled.
Stosch is the author of budget language this year that created the Medicaid Innovation and Reform Commission and gave it the power to determine that Virginia had made sufficient reforms to its existing Medicaid program to allow expansion under the Affordable Care Act.
But the commission, consisting of 10 legislators and two Cabinet secretaries for Gov. Bob McDonnell, is under intense political pressure from both sides of a debate that has been building since the U.S. Supreme Court made Medicaid expansion a state option instead of a mandate.
The panel will hear testimony today at 1 p.m. from both sides of a partisan divide that is reflected in the federal government shutdown that was sparked by an attempt to defund “Obamacare,” the shorthand name for the 2010 health care law.
The commission already has received more than 1,800 comments and posted more than 900 of them on its website. The commission will accept comments through Wednesday for its next meeting on Monday.
The Virginia Hospital and Healthcare Association estimates that almost three-fourths of the comments support expansion of Medicaid to an estimated 400,000 uninsured Virginians, most of whom will not make enough money to qualify for federal subsidies in the new health insurance marketplace that opened for enrollment on Oct. 1.
“We ought to create the Virginia way,” said Katharine Webb, senior vice president at the Virginia Hospital and Healthcare Association.
But opponents have made their presence felt, both at previous commission meetings in Richmond and in the political districts of legislators on the panel.
Americans for Prosperity, a well-financed national organization that has led opposition in Virginia, has brought hundreds of activists in green T-shirts to commission meetings to voice their opposition Medicaid expansion.
“Virginia’s state legislators should know better and Americans for Prosperity will be present … to remind them that we oppose expansion,” said Dave Schwartz, the group’s Virginia director.
The organization has publicized door-to-door canvassing in the district of Sen. Emmett Hanger, R-Augusta County, chairman of the commission and a supporter of expansion. “In part, it’s just dovetailed with what’s going on at the national level,” Hanger said.
In the Richmond area, the group has targeted Sen. John Watkins, R-Powhatan, who favors reform and expansion of the program. And it has brought activists into the political districts of house members who are skeptical of expansion, such as Del. John O’Bannon, R-Henrico County.
“They have made a very high profile issue,” said O’Bannon, who appeared at a town hall meeting with the group earlier this month.
The intensity of political opposition has made an impression on Stosch, who said he also is concerned about continuing problems in enrolling people for insurance on federally run exchanges in Virginia and 35 other states since Oct. 1 and the taxes imposed by the law.
Stosch seeks a different approach in part because of what he called “the inability of folks to separate expansion from Obamacare.”
He also recognizes the difficulty of persuading commission members from the House, to agree to extend Medicaid coverage even if the state achieves the reforms specified in the budget language adopted this year. The language requires agreement by three delegates and three senators for expansion to proceed as early as next July 1.
Howell and McDonnell, both opponents of the health care law, call the conservative house delegation a “firewall” against Medicaid expansion, but some conservatives still distrust the budget deal as a backdoor way to expand the program.
Stosch and other legislators are concerned about the flow of taxpayer money out of Virginia to pay for health coverage in other states, without the state receiving billions of dollars in promised federal aid for Medicaid expansion.
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