The honeymoon, such as it was, is over. Terry McAuliffe moved into Virginia’s governor’s mansion little more than a fortnight ago, and already he’s spoiling for a fight with the legislature. The Democratic bag man set the stage for his first clash with the Republican-dominated General Assembly over expansion of the state’s Medicaid rolls under Obamacare, which the U.S. Supreme Court ruled was an option, rather than a requirement, for the individual states.
Despite the governor’s postelection wooing of Republicans — whose help he must have to enact his agenda — by promising a business-friendly administration and appointing a relatively moderate Cabinet, the bloom is off the rose. A marriage of convenience is rarely a happy one.
Mr. McAuliffe wants to put 400,000 more Virginians on the dole with Medicaid, the federal-state health care program for the poor. Obamacare provides financial incentives to states that agree to expansion, but Virginia Republicans are resisting, saying the scheme is too expensive, and in any case shouldn’t be done absent reforms first.
Mr. McAuliffe is angling to circumvent lawmakers by wresting the power to expand Medicaid away from a state legislative commission studying the issue. He announced last week that he would use a budget amendment to get his way if the state Medicaid Innovation and Reform Commission doesn’t agree to expand Medicaid before the General Assembly wraps up for the year in March.
Even if the closely divided state Senate were to approve Mr. McAuliffe’s budget amendment, it would still have to clear the House of Delegates, where Republicans hold a two-thirds majority. That’s not likely. Turning down Medicaid expansion means refusing the “free money” of federal aid, but Republicans argue that it’s foolish to think that the “free” cash will last. Once the feds turn off the spigot, the state would have to find a way to pay the $2 billion annual bill.
Medicaid is bloated enough and represents one of the largest line items on any state’s budget. An April 2012 report by the House Oversight and Government Reform Committee estimated that Medicaid would cost taxpayers $457 billion that year, and that while the extent of waste, fraud and abuse in the Medicaid program is unknowable, “it may exceed $100 billion a year.”
Further expanding a program hurtling toward insolvency, with $1 of every $4 wasted, would be the height of irresponsibility.
The public agrees. A new poll finds most Virginians disinclined to expand Medicaid. The Roanoke College Institute for Policy and Opinion Research survey released last week found a combined 59 percent said either it shouldn’t be expanded at all (26 percent), or expanded only after it is reformed (33 percent).
Reform of any federal program, as we all know, will occur on or about midnight on the 12th of never.