04/10/14: The legislature’s dereliction of duty

This op-ed appeared in The Virginian-Pilot on the date shown.

THE BUDGET impasse over the expansion of Medicaid is likely to continue for a while, as both sides have dug in their heels. Meanwhile, Virginians who fall into the coverage gap continue to go without insurance, and local budgets remain in flux. Rhetoric, not based in reality, has driven the conversation.

It’s time for the General Assembly to do its job and come up with a solution beneficial to the people of Virginia.

Legislators calling for the passage of a “clean budget” are being disingenuous: This fight over health care reform was partially created by a budget amendment.

When the legislature passed a transportation financing package last year, it did so with the support of Democrats, who went along with this signature achievement of the McDonnell administration in exchange for what they thought to be a path for the expansion of Medicaid.

They were mistaken.

Language was inserted into the budget that created the Medicaid Innovation and Reform Commission. The commission’s charges were included in its name, and it was to consist of 10 voting members, five each from the House of Delegates and the Senate.

The chairmen of the money committees in each chamber — the House Committee on Appropriations and the Senate Finance Committee — were included on the commission, and they were each charged with appointing four other members from their respective committees.

If the name of the commission wasn’t clear enough, the explanation included was: “Language requires an affirmative vote by a majority of the members appointed from each body to approve [of] Medicaid expansion for newly eligible individuals pursuant to the Patient Protection and Affordable Care Act.”

At the time of the bill’s passage, Republicans were in control of both chambers. In the Senate, though, there was a bipartisan mood in favor of expansion. The House was another matter: All five of its appointees opposed the expansion. The speaker of the House and then-Gov. Bob McDonnell both opposed Medicaid expansion and referred to the House members on the committee as a “firewall” against it.

The budget amendment required that MIRC meet bimonthly, beginning last June, and through the end of 2013, it did meet. Despite all of the rhetoric from the General Assembly this year, MIRC did not hold a single meeting in 2014 until Monday.

In the interim, a war of words has flooded the commonwealth’s newspapers as supporters and opponents have taken the opportunity to have their positions heard.

The MIRC has shirked its duty, and those who say “let the commission do its job” are well aware of it. But the fact that it was included in the budget makes the cries of passing a “clean budget” ring hollow.

MIRC isn’t the only reason, though.

One of those who penned an op-ed column was Republican Sen. Walter Stosch, a member of MIRC and the co-chairman of the Senate Finance Committee. In it, Stosch points out that as early as 2012, McDonnell included in his budget proposal provisions that would recover ACA funding. “Both budgets,” wrote Stosch, “passed this year by the House and Senate appropriate money to implement the ACA as well.”

Can we put that “clean budget” thing to bed now?

Stosch is in favor of using a market-based alternative to covering Virginians rather than outright Medicaid expansion. He first offered a solution during the 2013 session but it was rejected in favor of the MIRC budget amendment.

Stosch is no supporter of the Affordable Care Act, but he argues that “it is the law of the land.” He considers it the responsibility of the legislature “to find a commonsense solution that makes the law as manageable as possible for our citizens.”

As the only certified public accountant in the legislature, Stosch is also looking at Virginia’s bottom line. He says failure to include Marketplace Virginia, as the proposal is known, will cost us $285 million in indigent care savings over the next two years. That money would be added to the commonwealth’s general fund and used to pay for other items, such as schools.

Stosch is right. This game of chicken over the implementation of the ACA has to stop.

Until the ACA is repealed, the legislature has a responsibility to do what is best for the citizens of Virginia. Rejecting the money is dereliction of duty — by the members of MIRC and the other members who are using its lack of action as a shield.