Medicaid expansion

The “Veto” Session commenced at noon on Wednesday, April 3, 2013, and finished at 1:00 a.m. the next morning. It is hard to believe that we could take so long, but most of our time was focused on electing new judges around the Commonwealth in a Special Session.

The Governor made numerous recommendations for changes in bills that had been previously passed by the General Assembly. The most notable of these involved modifications in the transportation bill, which had been passed by a bipartisan coalition in the House and Senate. The Governor’s changes reduced the size of the plan somewhat and included a small reduction in the “hybrid tax”; the $100.00 fee was reduced to $67.00. The fiscal impact of that action was not large, but was viewed as a symbolic change designed to mollify some of the critics of the original bill. Most of the major increases in revenue remained, including the provision to create a dedicated source of revenue for passenger rail. I was happy to advocate and vote for this bill as the most significant advancement in the transportation funding that has been made in several decades (my speech on the original measure is available here). The measure raises about $1 billion extra per year and includes greater sums for transit, road maintenance, and passenger rail. Finally, the Governor made some changes designed to address concerns about the constitutionality of certain measures in the bill that provide some additional revenue for Northern Virginia and Hampton Roads. Democrats again provided the margin of victory for final passage, as numerous “no tax pledge” Republicans deserted the Governor by failing to support the measure.

The Governor made some changes in budget language that may assist those of us who seek to expand Medicaid in the Commonwealth. My position continues to be that Medicaid expansion is good because it will create 30,000 new jobs in Virginia, insure approximately 300,000 Virginians who do not have coverage at present, allow the return of billions of dollars in Virginia tax monies that would otherwise go to states throughout the country that have embraced Medicaid expansion, and will be 100 percent funded by the federal government for the first several years of the expansion. It will reduce pressure on our emergency rooms, which have become the “health insurer of last resort” for many of the poorest in our region. Using emergency rooms for primary care is very inefficient and raises costs to taxpayers (the state reimburses hospitals for emergency room bills that are not covered by insurance and that individuals are unable to pay) and to those of us who have private insurance coverage.

A day in Richmond at the General Assembly would not be complete without a debate on social issues. This time it was the Governor who was pushing the social agenda, as he inserted language into a bill that would prohibit private health insurance companies from offering health care coverage for abortion as part of private insurance that would be purchased by individuals within the new health care marketplace. A majority in the House and Senate embraced the Governor’s language, despite the arguments of many Democrats (myself included) and some Republicans that this was an unnecessary and unreasonable intrusion into the marketplace, where private buyers and sellers negotiate the terms of the coverage that companies provide. Our further concern is that it could drive certain citizens away from the health exchange, with the result that either they do not get any coverage at all, or because the insurance pool would become smaller, the cost of insurance would rise for other people who seek it. This is not good social policy in a Commonwealth seeking to lower the cost of insurance for everyone and looking to the marketplace for solutions.

Finally, the 16th Judicial Circuit, which serves this area, got two new judges late in the evening. The first is Dale Durrer, who resides in Culpeper and will serve on the General District Court, replacing the Honorable Roger Morton, who recently retired. The second is Claude Worrell, II, an Assistant Commonwealth’s Attorney in the City of Charlottesville, who will take the seat previously occupied by the Honorable Dwight Johnson, who retired in January. I expect that these gentlemen will make fine judges, and am very pleased that we were able to retain these judgeships for our community.

With the completion of the Session, my attention returns to constituent service, my law practice, and the fall elections. It is a pleasure and honor to represent you in the Virginia House of Delegates. As always, please feel free to contact me to share your thoughts and comments on matters before the Commonwealth.

Sincerely,

David

The 2013 session of the Virginia General Assembly adjourned on Saturday, February 23rd at 5:21 p.m., with the passage of what is arguably the most significant legislation with which I have been involved since I took my seat in 2006.

This session will be remembered primarily for two issues – transportation and Medicaid.

Transportation

When this session began on January 9, 2013, few would have predicted that we would ultimately pass the most significant transportation plan since 1986. This was not easy, and it almost unraveled at the last minute due to the intervention of our Attorney General, who had opposed any increases in transportation revenues, even the inadequate proposal that the Governor made in January. The Governor’s initial proposal failed to raise sufficient revenue for transportation, was built on an assumption that we would receive money due to federal action that no one was sure would occur (enactment of the Marketplace Equity Act, a.k.a. “internet sales tax”), and took the wrong approach on policy grounds by eliminating the gasoline tax while raising the sales tax. I originally opposed this proposal, and voted against it when it was first considered on the House floor.

But then things changed dramatically.

Frequent direct contact with the Governor’s office and the willingness of the Democratic Caucus to stick together on what was needed for this package were instrumental in modifying the plan as it continued through the legislative process. What ultimately emerged was a transportation plan which, while not perfect, included significant new revenues, approximating $1.4 billion extra per year for transportation construction, maintenance, transit, and rail. I have described this package in greater detail in a letter that I have sent to those who have contacted me on this matter. As a result of these significant and sustainable increases in revenue, I supported this bill. You can view the clip of my speech on the House Floor supporting the bill on YouTube.

One of the most heartening elements of this session was the degree to which the House Democratic Caucus was able to make the difference in passing the transportation plan. Without House Democrats, this plan would not have passed — there were simply not sufficient Republican legislators who were willing to support it. This is one of the untold stories of the 2013 session and one that should not go unnoticed for the future. While our numbers in the House are not as large as we would like, we clearly made the difference in a plan that is the most significant passed in the last twenty-five years.

Medicaid Expansion

On the Medicaid front, many of us argued that Medicaid expansion makes good economic sense for the Commonwealth while allowing more than 250,000 Virginians to get access to health insurance. Many hospitals and medical professionals in the Commonwealth argued for expansion because it would create 30,000 jobs, bring approximately $9.9 billion to the Commonwealth, and would provide a vehicle to discourage individuals without insurance from using the emergency rooms of our hospitals to meet their primary care needs – a costly way of providing care and one that ultimately raises costs for every Virginian who buys private insurance or is insured through their job. You can view my speech here.

The Governor and conservative members of the General Assembly, primarily in the House, vehemently opposed Medicaid expansion, feeling that it would place greater costs on the Commonwealth and would provide legitimacy to “Obamacare.” This is their sentiment despite assurances that 100 percent of the cost would be paid by the federal government for the first 3 years, and then 90 percent in future years. At present, the federal government pays 50 percent of Medicaid expenses.

Many of us further argued that failure to expand Medicaid would mean that Virginia tax dollars would be used to help fund Medicaid expansion in states who had decided to do so. Nationally, many states with Republican governors and statehouses, including Arizona, Ohio, and most recently, Florida, have decided that Medicaid expansion makes good economic and human sense and, therefore, have embraced expansion. Governor McDonnell, however, has consistently said no. What emerged in the final days of the General Assembly session was reform language that was placed in the budget to create a commission to determine whether and when reforms had been enacted sufficient to justify expansion in Virginia. It is not the approach that I would have taken, but it represented the best that we could do to move expansion forward.

At the last minute, however, Attorney General Cuccinelli issued an opinion that he believes such an approach is unconstitutional. This opinion had the effect of almost derailing passage of both the budget and the transportation plan. Cooler heads prevailed, and the Medicaid expansion language was accepted by the House and the Senate, enabling both the budget and the transportation plan to pass.

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The significance of transportation and Medicaid overwhelmed other measures that were considered during this session. It was disheartening to watch as important bills were not passed, notably measures to restore voting rights to non-violent felons, eliminate workplace discrimination based on sexual orientation, and make our streets and roads safer for pedestrians and bicyclists. Future updates will detail these and other pieces of legislation, including changes in energy policy, some educational reforms, pay raises for teachers and faculty, prohibitions against texting while driving, and a new program to allow vital records to be issued by DMV.

I look forward to being back in Charlottesville with family and friends, and resuming my law practice. As House Democratic Leader, I will be traveling the state this year in an effort to increase the number of delegates who share our values in the General Assembly.

It is a pleasure and honor to represent you in the Virginia House of Delegates. As always, please feel free to contact me to share your thoughts and comments on matters before the Commonwealth.

Sincerely,

David

Reconvene Session Passes Transportation Plan, More Restrictions on Abortion

Session Ends with a Bang

Transportation

Medicaid Expansion

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