The conservative group Americans for Prosperity organized a public forum in Charlottesville this week to discuss Medicaid expansion. The featured speakers were two Republican Delegates who strongly oppose the idea, but it seemed they had come to the wrong place, as supporters packed the auditorium.
About 150 people gathered outside the Albemarle County Building holding signs that encouraged honks of support for expanding Medicaid. Thousands of people in this city work for the University of Virginia Medical Center, Martha Jefferson Hospital and other healthcare organizations that currently absorb the cost of caring for poor people who don’t qualify for Medicaid now.
Inside, the moderator described the sponsoring organization, Americans for Prosperity - a group founded by wealthy industrialists David and Charles Koch.
“We are a grassroots organization.”
Faced with a hostile audience, Delegate Rob Bell attempted to change the subject, listing popular bills the House had approved during the last legislative session.
“We did work hard on mental health reform. I think most of your know that we had a terrible tragedies with one of our colleagues whose son was mentally ill.”
Bell then outlined his concern with expansion of Medicaid - a growing expense for the state.
“Medicaid has grown in 1985 from five percent of the budget to its current 20% of the budget. It will be 22% of the budget, absent any expansion. I believe that’s unsustainable.”
He did not mention that the federal government will pay the full cost of Medicaid expansion for the first few years and will then scale back gradually to cover 90%. Over that time, the cost of medical care in this country is expected to drop as the system puts new emphasis on prevention and treats illness before it gets worse and more costly to cover.
Delegate Steve Landes said he was reluctant to approve Medicaid expansion without fully understanding the program.
“The Secretary of Health and Human Resources could not definitely say this is exactly how it’s going to work, this is exactly what it will cost, this is exactly what we’re going to save.”
But the public was having none of it. Attorney Doris Gelbman said Medicaid costs had risen in part because we’re an aging nation, and the sickest of our elderly are covered by both Medicare and Medicaid. She demanded to know how these two lawmakers thought younger adults who are poor could get attention for their medical problems.
“Medicaid covers poor children, poor pregnant women and poor old people. It does not cover you if you are over 18 and under 65. You could be living on the street, and Medicaid will not cover your healthcare.”
The forum lasted more than two hours, but Delegate Bell wasn’t budging.
“I understand that you think it’s important - that down in your soul you think this is the most important thing in the world. Just for a nanosecond, turn around and understand how that feels to be on the other side. I respectfully disagree and think this is a bad idea, not a good idea.”
Governor McAuliffe has said he won’t sign a budget bill without Medicaid expansion. But Republicans in the House - like Bell and Landes -- are equally adamant, setting the stage for a shutdown of state government at the end of the fiscal year, June 30th.