Bolling against Medicaid expansion; McDonnell has not made a decision

Virginia Lt. Gov. Bill Bolling has asked Gov. Bob McDonnell to reject the federal health care overhaul’s Medicaid expansion, days after Mr. McDonnell said there were too many unanswered questions to make a decision yet.

The open push, while not a bona fide break from the Republican governor — they both oppose the law and say they are hopeful it’s repealed — is a slight departure as Mr. Bolling works to position himself for a GOP gubernatorial run in2013.

“Until and unless there has been significant and fundamental reform of Medicaid, I urge you to reject expansion of this program,” Mr. Bolling wrote. “This is a program that does not work now, and it will not be improved by simply making it bigger.”

Mr. McDonnell, meanwhile, wrote to state legislators that before a decision on the expansion is made, the state needs to consult with the Department of Health and Human Services.

“A great expansion of Medicaid, without significant reform of the current so-called, ‘federal-state partnership’ is not responsible,” he wrote.

The letter comes a day after Mr. Bolling revealed that he raised nearly $1 million in the first six months of the year and a poll showed him faring better against likely Democratic candidate Terry McAuliffe in a general election than his Republican primary opponent, Attorney General Kenneth T. Cuccinelli II.

Noah Wall, Mr. Cuccinelli’s political adviser, said he would not implement the Medicaid expansion either, but his fundraising numbers were not available.

J. Tucker Martin, a spokesman for Mr. McDonnell, said he appreciated the letter and will review it thoroughly and that Mr. Bolling is correct when he says the program keeps getting more expensive and cannot be sustained without major reforms.

The U.S. Supreme Court, in ruling the health care law constitutional, also said the federal government could not withhold current Medicaid funds if states do not expand the program.

GOP governors in six states already have indicated they will not comply with the expansion of the federal-state health care program for the poor to individuals and families with incomes of up to 133 percent of the federal poverty level, which is $14,856 for an individual and $30,656 for a family of four.

The federal government will cover 100 percent of the costs of newly eligible consumers through 2016, with the subsidy gradually decreasing to 90 percent in 2020 and thereafter.

“Medicaid is a good deal when it’s 50 cents on the dollar,” said Delegate Patrick A. Hope, Arlington Democrat and director of legislative policy at the American College of Cardiology. “It’s an even better deal when it’s 100 cents down to 90 cents on the dollar.”

House Democrats also prodded Mr. McDonnell to act on applying for grant money to set up a state health benefit exchange - a marketplace where consumers can shop for and purchase insurance starting in 2014 under the law.

“It is time for leadership, to quit posturing, to use our share of federal money, and to send a Virginia plan to the Obama administration - an exchange proposal that meets our needs, and makes the right decisions for Virginia even if every federal regulation is not yet clear,” said House Minority Leader David J. Toscano, Charlottesville Democrat.

McDonnell spokesman J. Tucker Martin, though, said that wasn’t going to happen.

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