Emmett Hanger: A Republican who supports Medicaid expansion

Dr. Quentin Kidd, Director
Wason Center for Public Policy

Director Kidd:

Hope all is well with you. I expect you may be busy as your most recent poll perhaps has caused a few people to contact you with reactions and questions.

I tend to take things in stride, recognizing that the “wind blows both ways” and opinions shift drastically depending on the focus of the moment. However, I do want to take this opportunity to express significant concern over the design of your poll.

Perhaps I am overly sensitive but it seems that if you say in your question pointedly that the Democrats want to expand and the Republicans don’t want to, that you are prejudicing the outcome. My issue is that I have been from the very beginning a leader in the push to reform Medicaid and then set up a mechanism to expand coverage using the federal dollars that are available for this purpose. As you are aware, I am a REPUBLICAN!

Further, in my opinion, your relevant question in the recent query  amounted to a not so subtle “push poll”.

There was no expanded explanation of why “Democrats” want to expand but the often quoted mantra of the opponents of expansion, “the federal Medicaid money will not come as promised” and the “Medicaid program has too much waste and abuse and needs reformed”  was offered as “Republicans” reasoned approach to opposition.  Actually your recent question matches up well with the February question that asks if federal money were not available would they still support expansion. Not really any change in public opinion.

Further the question in this form is not particularly relevant to the current debate for the following reasons: (1) We are not proposing to expand traditional Medicaid, we are proposing a private option plan  based on cost controls achieved through managed care; (2) We are proposing that if federal money is not there, then Virginia’s expanded coverage will be retracted; and (3) Support of the expanded coverage has been conditioned on an aggressive series of reforms to our Medicaid system that are in fact addressing the perceived weaknesses in our existing program.

Excuse my sensitivity, but there will be no winners in this debate if we allow partisan politics to chart the outcome. The press portrays the debate as a political contest; Governor McAuliffe and the Senate Democrats against the House Republicans. The real debate needs to get refocused on viable options for reforming our healthcare delivery system in Virginia so that people don’t have to bankrupt their family over a broken arm or die prematurely because they put off a timely treatment that they feared they couldn’t afford.

I understand that you don’t control the public debate that forms public opinion, but I hope you understand my concerns. The dissemination of misinformation seems to be more prevalent than an attempt to educate the public on this issue and those of us that are advocates have perhaps not done a good job of getting our message out. To that end, if there is an interest at your University in a presentation or a debate, I would be pleased to participate.

Thanks so much,
Emmett Hanger