Home Virginia Politics Video: Forum on Virginia Medicaid Expansion Makes Clear There’s No Good...

Video: Forum on Virginia Medicaid Expansion Makes Clear There’s No Good Reason to Oppose It


Earlier this afternoon, I attended a town hall forum on “Closing the Coverage Gap” in Virginia at the Arlington Central Library. The panelists were: Senator Adam Ebbin, Senator Barbara Favola, Delegate Bob Brink, Delegate Patrick Hope, Delegate Alfonso Lopez, INOVA Health System representative Don Harris, and Virginia Deputy Secretary of Health and Human Services Jennifer Lee. The first video has Del. Lopez welcoming the audience – disappointingly small (maybe a couple dozen?) from my perspective, especially given the urgency and importance of this issue to all of us – followed by the panelists introducing themselves. I’ll post more videos in the comments section of this post. The bottom line, from what everyone said today, is very simple: there are a bunch of great, substantive reasons FOR expanding Medicaid in Virginia, and ZERO serious, substantive reasons AGAINST it. So why isn’t it happening? One reason, and one reason only: incumbent Republicans are terrified of the Tea Party, which hates “Obamacare” and President Obama with a deranged passion, and their gerrymandered districts mean that this is the only realistic way they might not be reelected. So, yes, opposition to Medicaid expansion is rational from the narrow self-interest point of view of individual Republican Senators or Delegates, but simultaneously it’s hurting their constituents, as well as the rest of us in Virginia. Priorities, priorities…

P.S. The Virginia General Assembly is back in (in)action Monday, and Gov. McAuliffe has promised a “major announcement.” Stay tuned!

  • Del. Bob Brink responds to a question about why people in Virginia’s “red” districts – which also, by the way, have (by far) the greatest need for Medicaid expansion in the state, since they are the poorest, most rural districts – keep voting against their own self interest, and why their delegates keep acting against their constituents’ self interest. Brink’s answer is that gerrymandering has resulted in “red”-district delegates only having to worry about ONE thing politically – “a primary challenge from a Tea Party candidate.” And, Brink added, “the Tea Party is virulently, virulently opposed to the Affordable Care Act and to the president who enacted it.” In addition, Republicans just last years saw two Republican delegates (in Loudoun County and Winchester) defeated by Tea Party challengers. In Brink’s view, “every Republican member down there has a picture of those two defeated delegates on their wall, and that guides a large part of why we are where we are on this.”

  • Sen. Favola: “I want to say that our Senate conferees – which are Democrats and Republicans – are going to hold firm on a budget that has Marketplace Virginia; in other words, they are unwavering in their support for Marketplace Virginia…We are united…23 solid votes in the Senate that are not going to budget if Marketplace Virginia or some version of Marketplace Virginia are not in the budget.”

    Del. Lopez: Majority Leader Dick Saslaw says he is unbudging…and the Governor as well.”

  • Sen. Ebbin: “We’re all victims of Stockholm Syndrome, in that we’re all thinking about how can we convince our colleagues to change. The discussion’s been focused on trying to meet some of the objections from Republicans who would say, oh it’s a big government program…welfare expansion for 400,000 Virginians…What we need to do is also how we’re going to turn this discussion around,” so everyone needs to reach out to their networks and make the case for why we need Medicaid expansion.

  • Ebbin: “The Senate has another option, which is expanded Medicaid coverage but we’re calling it Marketplace Virginia. This was come up with by a Republican Senator and some Democrats to take the public money…and allow those same people to be eligible to buy private plans…We’d have an annual audit…at the request of our colleagues we’d also have a work requirement…they wanted that in there.” The bottom line, in Sen. Ebbin’s view, is that it isn’t a question of IF we expand but HOW we expand Medicaid.

  • One quibble: Virginia actually runs anything BUT a “tight ship” in its budgeting. Why do I say this? Because Virginia wastes hundreds of millions of dollars per year (or more) on all kinds of wasteful welfare and tax breaks to wealthy individuals and corporations (e.g., the estate tax elimination costs Virginia around $140 million per year, every single year). If we were truly a true “tight ship,” we’d ditch all the taxpayer giveaways to people who don’t need it. But we aren’t, so we don’t. Meanwhile, we have to scrimp a few bucks here and a few bucks there to provide the most basic of services – mental health, brailled instruction for students who are blind/visually impaired, etc, etc. Disgraceful.

  • For instance: a) costs for charity care at hospitals are being passed on to the business community via higher premiums to their employees; b) smaller/rural hospitals could actually go out of business; c) hospitals like INOVA will have to slash education programs, research, investment in facilities, medical equipment (e.g., new CT scan machines) so they won’t have the most modern equipment. So stupid…and so Republican!

  • Hope: “A large majority of the country is going to expand Medicaid. And you can’t emphasize the economics of this enough. We are already paying for the people that are sick. The Supreme Court made it optional for states to expand Medicaid. But what they didn’t make optional is for the amount of money that taxpayers are paying for Medicaid expansion. If you think that we can get out of participating in the Affordable Care Act, we are already on the hook…your tax dollars, $5 million a day…are going to the federal treasury and they’re not coming back…So we’re already paying for the sick, and we can’t wave our magic wands and hope that people don’t get sick…The economics of this are just so overwhelming.”