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Virginia in a box on Medicaid, Affordable Care Act

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virginia general assemblyBe careful what you wish for, because Virginia Republicans got theirs, and seem to want to give it back.

“One of the reasons we did not expand Medicaid is we did not trust the federal government to make good on its promise. Block grants are the same thing,” House Appropriations Vice Chair Steve Landes, R-Weyers Cave, told the Richmond Times-Dispatch, after a briefing from Secretary of Health and Human Resources Bill Hazel on the impact that the replacement of the Affordable Care Act with federal block grants would have on Virginia.

Hazel told legislators that Virginia could stand to lose more than $300 million in healthcare funding in the next two years.

The reason: block granting funds would reward states with high Medicaid spending per capita. Virginia, led by Republicans in the General Assembly, resisted expanding its Medicaid program, ostensibly out of fear that ACA funds would eventually drift away.

But, come on, seriously, who didn’t foresee that the end of ACA wouldn’t come with that favorite Republican parliamentary maneuver, the block grant?

The lack of foresight means that Virginia is now left to hope that Congress doesn’t do what it seems pretty clear it’s going to do.

“Congress needs to be very careful in considering repeal not to throw the baby out with the bathwater,” Hazel said between separate briefings for House and Senate committees.

Yeah, there we go, threatening Congress with … what?

In fairness to Hazel, this isn’t a crisis of his doing. Gov. Terry McAuliffe, a Democrat, has been trying since his inauguration in 2014 to get the General Assembly to expand Medicaid, only to be rebuffed at every turn in what were clearly a series of political moves by Republicans.

“Congress is in a box, but it’s a box that they chose,” Senate Finance Co-Chairman Emmett Hanger, R-Mount Solon, said Monday.

Due apologies to Hanger, but it’s not Congress that is in the box, but us, and we chose it.

Column by Chris Graham

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