Medicaid: Plotting A Steady Course

The biggest decision of this 2014 session of the Virginia Legislature will be whether or not to accept the cash incentives offered by the Federal government to persuade Virginia to permanently expand Medicaid. I am very glad to say that the Republican leadership of the Virginia House is weighing this carefully and understands that anything worth doing is worth doing right. This decision will have far-reaching ramifications for the future of our Commonwealth.

Let me be clear: I strongly believe we have a duty to provide for the folks around us who need healthcare. The means we should choose to do this may be an issue of contention, but to the degree it’s ethically and practically possible, we should do what we can to help the most vulnerable members of our society to gain access to the care they need.

However, before we rush to accept the Federal plan, we must consider a few oft-neglected facts:

Medicaid already dominates spending in the Commonwealth, consuming more resources and growing faster than any other part of our operating budget. It needs to be studied and revamped.
Virginia’s Medicaid spending has increased from $1.8 billion to $3.7 billion over the last 10 years, more than a 105% increase. I repeat for emphasis, that increase is only over the span of 10 years! This is not sustainable.
Even with new reforms my fellow Delegates and I are currently advancing to clean up Medicaid, the program will consume 40% of the new resources available to Virginia for the current budget biennium.
In Maine, an in-depth actuarial study on the long-term effects of expanding Medicaid concluded that costs would rise astronomically even after Federal aid is taken into account. A report of Maine’s Medicaid finances show the expansion would cost the state an estimated $807 million dollars over the first 10 years alone!

Proponents of Medicaid usually point to the Federal government’s offer of “free money” as a key reason to accept expansion. I hope you’ll understand if, after years of repeatedly broken promises surrounding Obamacare, I’m decidedly skeptical of Washington’s intentions and ability to deliver on their future commitments. As enticing as this may appear to be, extreme caution is a must. It’s important to remember Virginia’s existing commitments to our current Medicaid enrollees. When faced with soaring cash needs, the legislature historically takes two approaches; either to raise taxes, or to slash benefits for those currently using the system. If we rush into this Medicaid expansion, we will put the benefits of current enrollees on the chopping block, and worse yet, when faced with the constitutionally mandated balanced budget, cost cutting to backfill Medicaid might well lead to cuts in other essential services.

While running for office, I pledged to support legislation that would get our economy back on track, help businesses prosper, and create jobs our citizens need. As things stand, I cannot keep that commitment and support the expansion of an already bloated government program that is rife with fraud and abuse, a program that if expanded will bleed our economy dry. Americans for Prosperity Maine said passage of the law in Maine will lead to what it called a “Medicaid Pac-Man” that will gobble up money needed for other essential services.

The Virginia way defines us as being thoughtful and deliberative with important decisions and ultimately demands that what we do, we must do right. I will continue to listen to the advocates of Medicaid expansion carefully, and I will continue to support efforts to reform this program, but before we sign onto a commitment like this, we must have solid evidence that it will be a net benefit to Virginia. When I consider the facts presented so far, I see opting into expansion of Medicaid as it is presented now is a recipe for financial disaster.