Virginia’s Ken Cuccinelli — the loudest critic of health care reform — went down in defeat on Tuesday night, paving the the way for the “bellwether for national politics” to expand Obamacare to nearly 400,000 Virginians.
A 10-member panel is currently considering whether the state should accept federal dollars to provide insurance to individuals and families below 133 percent of the federal poverty line ($31,321 in income for a family of four) through its Medicaid program. The decision still has to be approved by a majority of delegates and senators on the panel, though McAuliffe could bypass the GOP-controlled group “by deciding whether to include the federal Medicaid money in the state budget.” On the campaign trail, he repeatedly promised to build bipartisan consensus over the measure, going so far as to say that “he would not sign a budget that did not include Medicaid expansion.”
Under the Affordable Care Act, the federal government will pick up 100 percent of the cost of growing the program from 2014 to 2016 and states would contribute 10 percent thereafter. The expansion is a good deal for the state: analysis from the Commonwealth Institute for Fiscal Analysis in Richmond finds that “net savings from Medicaid expansion would average about $135 million per year in the upcoming budget cycle,” as state would now “use federal funds instead of state dollars for these programs that already provide care to the uninsured in Virginia.”
But the policy has attracted strong opposition from conservative advocates funded by the billionaire industrialist brothers Charles and David Koch. Volunteers with Americans for Prosperity have launched a massive campaign targeting Virginia lawmakers considering expansion and are distributing flyers through door-to-door canvassing, attending committee hearings, and according to one lawmaker who has become a target of the campaign, intimidating constituents.
McAuliffe and Democrats predict that they can overcome this push. They point out that some Senate Republicans support extending coverage and predict that if both sides “give a little bit to reach an agreement” health care for lower income Virginians could become a reality. A majority of Virginia voters say they support the expansion.
Incidentally, Republican New Jersey Governor Chris Christie, the other big victor of Tuesday night’s election, also backs this aspect of reform. In February, Christie — who describes himself as a conservative — argued that “Accepting these federal resources will provide health insurance to tens of thousands of low-income New Jerseyans, help keep our hospitals financially healthy and actually save money for New Jersey taxpayers.” He estimated it would save residents $227 million in the next fiscal year.