Tuesday, April 15, 2014

Medicaid expansion ... looking for solutions instead of just saying no

It's an interesting stand-off in Augusta County with the discussion (or lack of for some) about Medicaid expansion and what to do about those who fall through the cracks of coverage. If I listen to those to the political right of me, the solution is that we should do nothing, shut down, just say no.

Quite frankly, I'm tired of being painted as the party of no. While I don't agree with Obamacare and I don't subscribe to the political decisions of the current president, it is what it is. After listening to the rants and vitriol for eight years against Republican President George W. Bush, I'm now hearing the same from the right side of the aisle against President Barack Obama and all Democrats.

Enough already.

Augusta County probably personifies the divide in the Medicaid expansion issue more than many because our delegates -- Steve Landes, Ben Cline, Dickie Bell, all Republican -- are staunchly against expansion while our state Senator Emmett Hanger, also Republican, wants to find a compromise.

Today's editorial in the Staunton News Leader said it well:
Last week, when most of  the country’s surviving presidents gathered to celebrate the 50th anniversary of the passage of the Civil Rights Act of 1964, George W. Bush said something that almost sounds quaint:
“A segregated society can never be a successful society, because the only success worth having is achieved together.”
Achieved together. Does that happen anymore in this country?
Good question.

I talked briefly with Senator Hanger last week about this very complicated issue. We haven't always agreed about his votes in Richmond but his pragmatic approach to Medicaid expansion is appreciated in today's politically toxic atmosphere. Indeed, it's put a target on his back from local far-right constituents who will probably -- most likely -- primary him next go round.

That reality is not lost on the editorial crew at the News Leader:
We are so divided on the role of government that for some the aim is not to achieve together but to stop their political opposition, at whatever cost.

When we do not like a law, some of us waste years trying to repeal it. Our elected leaders tread water in constant campaign mode, which is all about satisfying the loudest and the richest, not working for the good of all.

Nowhere is this more visible than the Virginia General Assembly, which cannot — because so far it will not — come up with a compromised solution to Medicaid expansion controversy.
Our General Assembly is made up of hard-working men and women who strive to represent their constituents and work long hours to do what's best. Having an election every two years may be a stumbling block to good governing. But in the spirit of good governing, the Medicaid Innovation and Reform Commission was formed and headed up by Landes and Hanger. The News Leader, referring to the commission, wrote:
MIRC, which some note, rhymes with “jerk,” was to study Medicaid expansion. Among its 10 members are State Sen. Emmett Hanger, R-Mount Solon, and Del. Steve Landes, R-Weyers Cave.

MIRC has met, but many of the 10 had no intent to agree to any Virginia benefit from the Affordable Care Act under any circumstances. Hanger has with others proposed a compromise called “Marketplace Virginia,” in which government money would fund private insurance for the poor. Landes, though, goes for satisfying the far right and says Marketplace Virginia simply is Medicaid expansion. He is wrong.

And we are stuck.

The middle understands that Obamacare is here to stay, like it or not, and want to make it work in Virginia.

The right points to the states where Medicaid expansion has not worked well while ignoring the states where it has. The right is also sick of compromising on legislation and losing winnable statewide elections.

And the left? Far-right talking points aside, the General Assembly has never been and certainly is not today a liberal bastion. The few who are there learned compromise long ago.
Virginia has a Democratic governor and a Democratically-controlled state senate. The News Leader opined, "Calling for a 'clean' budget, one that does not address Medicaid expansion, is simply disingenuous." I'm not sure if I agree with that; after all, we need the state budget passed so localities can go about the business of putting their own budgets in order. However, in politics the name of the game is using the leverage at hand. Both sides are doing exactly that.

In today's turbulent political waters, it takes a courage beyond what most understand to buck the base. Think back to Governor Bob McDonnell's battle with those in his own party last year over the transportation issue. He was the victim of some of the most vile, vitriolic bellowing I have seen -- from the right side of the aisle. So the News Leader noted:
At the Civil Rights Summit last week, where George W. Bush spoke of achieving together, Bill Clinton noted that political courage outlasts political capital. [emphasis added]
Very true.

The NL editorial concluded:
Democrats lost the south for a generation after the Civil Rights Act, but when they came back, they did something and agreed to a plan that had Republican roots, the Affordable Care Act.

Meanwhile, Virginia Republicans lose statewide races and refuse to compromise.

Working together, with give and take, usually works well in our country. Richmond needs to remember how to do just that.
Where will the Medicaid expansion hold-off go from here? I joined up with A Healthy Virginia Works, a group of chambers of commerce and hospitals as well as community leaders across the Commonwealth, in a quest to find answers and solutions. Senator Hanger and fellow senators have offered their Marketplace Virginia plan. Hopefully, that middle ground will be found, preferably sooner rather than later.

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