Arkansas to Virginia: More Medicaid brings ‘buyer’s remorse’


By Kenric Ward | Virginia Bureau

RICHMOND, Va. — Citing more than $200 million in “waste, fraud and abuse” in Virginia‘s Medicaid program, Republican leaders say expanding the program now would be throwing good money after bad. Like lawmakers did in Arkansas.

NO DEAL: Arkansas House Majority Leader Bruce Westerman urges Virginia not to follow his state into Medicaid expansion.

Still, state Democrats and a handful of Republicans in the state Senate are pushing hard and fast to extend the indigent-care program to 400,000 additional lower-income Virginians this year.

Arkansas House Majority Leader Bruce Westerman said he saw the same hurry-up tactics in his state, with subsequent “buyer’s remorse.”

“We just put another layer of complexity on top of a broken system,” Westerman said in a conference call with reporters on Tuesday.

Westerman’s Virginia counterpart, Kirk Cox, R-Colonial Heights, said the House received “a three-page summary and a PowerPoint presentation” touting the benefits of a “private expansion” of Medicaid.

“It’s a mirror of the Arkansas plan,” he concluded.


The so-called “private option” in Arkansas “confuses people,” Westerman said. He noted that the rush to passage in Little Rock was “reminiscent of (U.S. House Speaker) Nancy Pelosi saying Congress had to pass (Obamacare) to find out what’s in it.”

“It was sold as free money from D.C., but it’s not free, and strings are attached,” Westerman said.

Gary D. Alexander, Pennsylvania’s secretary for public welfare from 2011-2013, independently warned that complex federal formulas for determining federal matching funds “introduce a strange dynamic” to expansion.

“States will see a relative reduction in the federal match for the most vulnerable and needy Medicaid populations, but a relative gain in the match for the newcomers, namely the able-bodied living above the poverty line,” Alexander wrote in the Washington Times.

With the 2014 Virginia General Assembly in its last 30 days, hospital and Virginia Chamber of Commerce lobbyists have joined Democratic Gov. Terry McAuliffe in prodding lawmakers.

The GOP-controlled House that the Medicaid Innovation and Reform Commission finish its analysis first. MIRC is scheduled to finalize its report by year-end.

Questioning the Medicaid-expansion agenda — with start-up costs pegged at $24 million to $30 million — Cox said, “There are a lot of assumptions we don’t think will come true.”

One thing is certain, however, is the existing program is rife with problems.

Former Attorney General Ken Cuccinelli‘s Medicaid Fraud Unit recovered more than $200 million in ill-gotten benefits and payouts, said state Sen. Tom Garrett, R-Louisa.

MIRC Vice Chairman Steve Landes cautioned that proponents’ hoped-for flexibility in administering a “private” Medicaid program does not exist.

“Waivers are temporary. Expansion is permanent,” the Verona Republican said.

Cox discounted the notion that the business community is united behind immediate Medicaid expansion.

“The National Federation of Independent Businesses is against it,” he said.

House Appropriations Chairman Chris Jones added that other business leaders, including executives with other chambers of commerce, want the state to fix its Medicaid program before expanding it.

Kenric Ward is chief of’s Virginia Bureau. Contact him at or at (571) 319-9824. @Kenricward

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