Irresponsible tax policy and dubious economic philosophy are cornerstones of the Virginia Republican Party. But an adolescent reaction to the Patient Protection and Affordable Care Act, denying Medicaid expansion, may be the single-most critical fiscal malfeasance. Forget the poor (Republicans almost always do), local jurisdictions are paying the price.
I am going to use some dated data…conservative, so to speak. According to Pew Research, the 2011 per annum cost of health care for Virginia prisoners was $4,870. In 2013 there were 58,800 inmates in Virginia jails and prisons. That does not include the Federal prison population. Assuming the cost and population remained constant through the years 2014, 2015, and 2016, each year, Virginia taxpayers forked out $286,356,000 or so for prisoner healthcare that could have been reimbursed by expansion; and no good “conservative” would deny healthcare costs have increased during that run.
What you might not know: those inmates would be eligible for Medicaid under expansion and their care paid for with dollars your Republican General Assembly members refused on some obfuscated principle that ignores the real fiscal world.
You should also understand that this is really a double hit for Virginia taxpayers. We paid those hundreds of millions with our federal taxes and/or debt. Those hundreds of millions are gone from Virginia forever. We effectively helped pay for healthcare for residents of other states while we remain saddled with a legacy of debt incurred and added to our Federal deficit in our name.
So, ignoring the benefit of the billion dollars a year the General Assembly has squandered by not expanding Medicaid, which would have generated substantial infrastructure growth and revenues, there is an undeniable loss of something approaching a billion dollars in unreimbursed state and local expenditures to add to that.
A billion dollars that could have built, repaired, and upgraded a lot of schools or justified state employee raises, for instance. And when Republicans try to claim that this shortfall is a result of lower paying jobs being created in this economic environment, ask them why state revenues from payroll withholding have increased at the same rate as economic growth this last fiscal year.
Thanks a lot, Republicans.