02/28/13: More deception from Richmond

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

THE VIRGINIA General Assembly session ended with a flourish Saturday as two major bills — transportation and the budget — were approved and sent to the governor for his signature. The passage of the first was, in the minds of many, predicated upon the passage of the second, which itself was predicated upon the inclusion of Medicaid expansion.

Despite a last-minute effort by some to derail the expansion of Medicaid, as evidenced by an opinion issued by Attorney General/gubernatorial candidate Ken Cuccinelli, budget conference members crafted language that they said would allow for it.

Or did they?

Last-minute legislation is generally only available to the members of the legislature, and the few who are present in the Capitol when it is presented.

Such was the case Saturday, when the conference report on the budget was being discussed. While it eventually gets posted to the Legislative Information System online, the rest of us have to rely on the debate — and an occasional Twitter picture — to tell us what’s been cooked up.

Even the legislators have to rely on briefings given to them about what is in the document, since their late dissemination makes it difficult to read them. The conference report on the budget is 251 pages long.

Much of the floor debate Saturday centered on item 307 #20c of the budget, in which reforms to Medicaid as explained.

Little mention was made of item 4-14.00 #4c. The devil, they say, is in the details, and this section is where the devil resides.

Item 4-14.00 #4c — and yes, Virginia uses a strange numbering system for its budget that only budget specialists understand — establishes The Medicaid Innovation and Reform Commission.

This commission will be charged with reviewing the reforms set forth in the aforementioned item 307. No Medicaid expansion will take place unless the reforms are sufficiently implemented. An affirmative vote by a three of the five members from the House and three of the five members from the Senate is required to prove that is the case.

And therein lies the rub. Already, the five members of the House, appointed by House Appropriations Chairman Lacey Putney, have been announced. At least three of the five, including Portsmouth’s Johnny Joannou, have publicly expressed disapproval of Medicaid expansion. I’m told all five are against it.

The fear that the federal government will turn off the tap and not reimburse Virginia and other states as promised for the costs of Medicaid expansion is much of the driving force behind the opposition. I get that; after all, lawmakers in Richmond have done the same to the localities over the years, so they have experience with such behavior.

But there is a rather simple solution to that problem: Stop the expansion if Washington doesn’t pay up.

Instead, state legislators have used bait-and-switch tactics to make some think they are going to expand Medicaid, all while stacking the deck against it happening. I’d have much rather they just said upfront, as Gov. Bob McDonnell did, that Medicaid expansion will not happen in Virginia.

What makes these actions even harder to swallow comes courtesy of a recent Wall Street Journal editorial, which lays out how 49 states, including Virginia, are already gaming the Medicaid system to get the federal government to pay all of the costs of current Medicaid, instead of part of it.

Virginia theoretically receives 50 percent of the cost of Medicaid, while shouldering 50 percent of the burden. This “subsidy honeypot,” as The Wall Street Journal calls it, uses a scheme of “provider taxes” to extract from the feds an amount that offsets the state’s burden.

Hypocrisy, thy name is Virginia lawmakers.

Estimates are that about 400,000 Virginians will benefit from Medicaid expansion, creating about 30,000 jobs and injecting about $3 billion into our economy.

With the looming sequestration cuts, Virginia needs something to help keep us afloat. The argument that sequestration is bad for Virginia because it reduces federal dollars in our economy while simultaneously rejecting federal dollars for Medicaid that would also boost our economy is a schizophrenic one.

Virginia lawmakers need to come clean. Stop with the legislation-by-budget smokescreen that makes it appear that expansion will take place. Voters deserve a fair hearing on why the benefits of expansion are being rejected.