Why Medicaid Expansion Could Hinge On A Drawing By Lot

Jan 2, 2018

Four years ago, Terry McAuliffe was elected on, partly, a platform of expanding Medicaid. So far, he has been unable to deliver on that promise. But Democrats are hoping his last budget will plant the seeds for that to happen after he’s no longer in office.

One of the quirks of Virginia government is that newly elected governors are stuck with the budget put together by the previous governor. That means Terry McAuliffe has one more chance to expand Medicaid to 400,000 people who live in poverty or with disabilities, even though he’ll be gone by the middle of the month.

Former Republican Governor Jim Gilmore says McAuliffe’s inability to expand Medicaid is a signal failure of his administration.   “He’s made an effort to expand Medicaid, which I can tell you as governor is a very risky thing to do," Gilmore said. "And he’s made relentless efforts to do that, unsuccessfully.”

Gov. Terry McAuliffe

Two years ago, McAuliffe tied savings from Medicaid expansion to cutting the corporate tax rate. That was an attempt at a grand bargain. Republicans would get tax cuts and Democrats would get health care. But that didn’t work.

Delegate Marcus Simon, a Democrat from Falls Church, says it failed because Republicans hate Obamacare more than they love cutting taxes. “What’s different this time around is that he’s tied the savings from Medicaid expansion into specific spending programs, particularly around education and teacher salaries and things like that that you’d have to cut if you took Medicaid expansion out.”

Senate Republicans have already supported a version of Medicaid expansion. The holdup has always been House Republicans. So the real question will be whether they have 50 votes or 51 votes. That will be determined when the State Board of Elections draws a winner "by lot" later this week in one tied house race.

This report, provided by Virginia Public Radio, was made possible with support from the Virginia Education Association.