Home 2013 races Cuccinelli vs McAuliffe: Round One Goes to Terry

Cuccinelli vs McAuliffe: Round One Goes to Terry

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by Paul Goldman

As we predicted, the issue of Medicaid expansion would be seen by Republicans as a potentially big one for them in the 2013 Virginia governor’s race.

Brian Moran, Chairman of the Virginia Democratic Party, opened the door to it by not thinking through the politics, putting statewide Democrats in a potentially bad political box on the issue. Without thinking, Brian Moran just came out and attacked Governor McDonnell for not quickly agreeing, without any analysis, to the Medicaid expansion which was upheld as part of the Supreme Court decision declaring the President’s health insurance reform law constitutional.

If Brian had read the case carefully, he would have realized the decision created a new dynamic in the Medicaid program, which is currently a federal/state partnership. Before Chief Justice Roberts’ opinion, a state had little choice but to accept the federal mandate no matter the cost to the state budget.

But Justice Roberts, with the liberal Supreme Court Justices going along, decided the federal government had gone too far in terms of using its massive “coercive” power to force states to accept this latest expansion of Medicaid.  In the end, the liberals joined Roberts in agreeing to do away with the federal government’s ability to coerce the states by withholding federal money if governors – McDonnell, in this case – refused to accept the Medicaid expansion.

Brian Moran failed to learn anything from his failed run for governor, demanding that McDonnell accept whatever Washington wanted. That’s BAD POLITICS for anyone running for governor, at least historically in Virginia.

Moreover, given the current economic/fiscal situation for middle class families in Virginia – who Democrats are supposed to fight for – along with lingering doubts about the President’s health care reform among swing voters in next year’s governor’s election, the Medicaid expansion issue creates a situation requiring real political skill — not just a liberal or conservative knee-jerk reaction.

There are three general interests to balance here. First, there a lot of our fellow citizens whose quality of life, if not life itself, depend upon their being able to have access to quality medical care. Call this the Health Interest.

Secondly, there is the question of what this Medicaid expansion will cost and where Virginia will get the money. In that regard, there is the short-term outlook, with Uncle Sam promising to pay almost all the cost; and the longer-term outlook, which would find Virginia having to shoulder a larger and larger share of the burden, estimated to be in the billions of dollars. Call this the Fiscal Interest.

And third: What are the true facts about the level of need and the actual cost to the state of Virginia in terms of whether we do X or Y. The Governing Interest.

Brian decided to copy Mr. Cuccinelli only from the opposite point of view. Thus, Brian argued Virginia should do it without having all the facts, and Mr. Cuccinelli argued the state shouldn’t do it, also without having all the facts. To me, and to most Virginians, that approach to governing is the problem, not the solution.

But at least the AG is entitled to run his campaign however he wants. Brian Moran is NOT entitled to box in the 2013 Democratic candidate for governor.

All that being said, we now know why Cuccinelli is pushing Terry to take a position on the issue. Namely, the AG correctly figures there will be immense pressure from Brian Moran et al for Terry to take the Washington line on this. But is that good politics, much less good policy, for next year?

Let’s cut to the chase; Balancing the Health Interest, the Fiscal Interest, and the Governing Interest on this issue is not possible with a knee-jerk analysis. There are a lot of questions that need to be answered; this is not a simple Yes or No.

The Medicaid program itself is complicated in that every state gets to define the parameters. The Clinton and Obama Administrations never have questioned that, nor could they.

To be elected governor of Virginia, a candidate has to be seen as fiscally responsible. A Virginia governor needs to fiscally responsible. In addition, a governor has to show he can balance the Health and Fiscal Interests with governing skill.

For all those reasons, I don’t see any political advantage in Terry taking a knee-jerk position on this issue. Quite the contrary: I advised Chuck Robb, Doug Wilder and Mark Warner that there is nothing wrong with a candidate wanting more answers to tough questions. Indeed, how can Cuccinelli complain if Terry agrees with a conservative Republican governor that he needs more answers and analysis before deciding what is best for Virginia and her citizens?

Virginia elections are not won on the fringes. An incumbent presidential administration has a set of federal interests to protect, but there are other legitimate interests at the state level which only a governor can protect. There is big role for both.

Governor McDonnell is being paid to do the job: so let’s see what he advises and the reasoning thereof when he feels he has all the facts. We Democrats will hopefully have the facts needed, or we can seek more information. Nothing wrong with being thorough. At which point, we will almost surely have a far better solution for Virginia.

  • Elaine in Roanoke

    McDonnell and the next governor of Virginia have to balance those things you speak of with the need of an estimated 430,000 Virginians who now have no access to health care, except for tax-payer-subsidized and very expensive emergency rooms. Virginia already has one of the stingiest Medicaid programs in the entire country.

    The problem that the ACA seeks to solve by enlarging access to Medicaid was exemplified this past week as several thousand people in Southwest Virginia crowded into the latest RAM free clinic. One nurse reported that she identified 15 people in less than an hour who had blood sugars denoting that they should be on treatment for diabetes. They didn’t know because they never go to a doctor, except for emergency care at emergency rooms.

    There was a time during my lifetime when we still believed in investing in public health.

    Yes, Medicaid is a large drain on the state budget; however, perhaps the General Assembly should look to the 12.5 billion lost in revenue each year by tax exemptions, tax credits, etc. Maybe a reform in the state tax code would pay for both Medicaid and decent transportation solutions.

  • Elaine in Roanoke

    Washington Post:

    “Perversely, the states that get the best deal under the law are states like Texas [and Virginia], which have stingy Medicaid programs right now, and where the federal government is thus going to pick up the bill for insuring millions and millions of people. In states like Massachusetts, where the Medicaid program is already generous and the state is shouldering much of the cost, there’s no difference for the federal government to pay.

    “That is to say, the less you’ve been doing on Medicaid so far, the more the federal government will pay on your behalf going forward. And that gets to an irony of the health-care law: Red states have, in general, done less than blue states to cover their residents, so they’re going to get a sweeter deal under the terms of the Affordable Care Act.”

  • How has he lasted so long as the DPV Chairman with such internal disdain?