Medicaid pushers try to split GOP with subsidies


DIALING FOR DOLLARS: Sen. John Watkins, R-Midlothian, wants to use state insurance subsidies to garner GOP support for Medicaid expansion.

By Kenric Ward | Virginia Bureau

RICHMOND, Va. — A Senate plan to subsidize health care coverage for lower-income Virginians could cost more than expanding Medicaid, a congressional study says.

The nonpartisan Congressional Budget Office estimates that state premium assistance would run $9,000 per beneficiary per year. That compares to $6,000 for traditional Medicaid.

Arkansas instituted a subsidy program with federal funds, and lawmakers there are now running from its ballooning costs.

Virginia Sen. Mark Obenshain said the commonwealth should take heed.

“Qualifying private insurance plans would have to tailor their plans to Medicaid requirements, losing the (limited) flexibility they typically have in designing coverage options,” the Harrisonburg Republican warned.

“It’s Medicaid delivered via insurers, but it’s Medicaid nonetheless, with the U.S. Department of Health and Human Services severely limiting the ability of insurers to establish competitive plans.”

House Republican leaders agree that SB 45 — dubbed “Marketplace Virginia” — is a risky proposition.

“This proposal is simply Obamacare‘s Medicaid expansion by a different name,” House Speaker Bill Howell, R-Falmouth, said in a statement.

Howell reiterated House Republicans’ opposition to any expansion while the Medicaid Innovation and Reform Commission is studying the issue. The panel’s report is not due until year-end.

Still, SB 45 supporters — including GOP author Sen. John Watkins, a few other Senate Republicans and every Democrat, led by Gov. Terry McAuliffe — want action.

“All of us are paying $2.9 billion a year into a pot in the sky in Washington. Senator Watkins is attempting to get some of that back,” said Finance Committee co-chairman Walter Stosch, R-Henrico.

McAuliffe has said Virginia is losing $5 million in federal funding every day it doesn’t expand Medicaid to some 400,000 lower-income residents. The state currently spends about $4 billion on Medicaid.

Craig DiSesa, an expansion skeptic, says haste makes waste.

“Do not be fooled, (SB 45) is essentially the Arkansas plan which has been proven to be more of the same empty promises coming from D.C.,” said DiSesa, legislation director of the free-market group, Middle Resolution.

“If we lose this battle, Virginia will lose control of more than 25 percent of its budget over the next few years. And that will be just the beginning.”

As the 2014 General Assembly reaches its halfway point Tuesday, legislative maneuvers are ramping up. Rather than attempting to pass SB 45 as a stand-alone bill sure to be shot down in the GOP-controlled House, senators will likely put it in the overall budget package, forcing an end-of-session showdown.

Republican Sen. Emmett Hanger, who chairs the MIRC panel, believes House Republicans will back some form of Medicaid expansion. If 19 GOP delegates join the Democratic bloc, Medicaid expansion could have life.

MIRC vice chairman Steve Landes, R-Verona, and other House HOP leaders aren’t budging. They accuse McAuliffe and company of banking “on borrowed money and empty promises from the federal government.” On Monday, the House voted 70-29 to order a detailed audit of the state’s Medicaid program.

“We have been very clear that we do not think any plan that accepts federal funds is good policy. Betting the fiscal future of the commonwealth on an IOU from Washington is a bad idea,” Howell said in a joint statement with Majority Leader Kirk Cox, R-Colonial Heights, and Appropriations Chairman Chris Jones, R-Suffolk.

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

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