The possibility that Gov. McAuliffe would unilaterally expand Medicaid in Virginia — and in the process, spark a constitutional fight with the General Assembly — is over. Instead, the Governor has opted for something far more restrained:
The proposals he unveiled Monday, however, were much more modest, primarily designed to improve care for people already in Medicaid and boost outreach efforts to people who qualify for it but are not enrolled.
The plan was billed as improving health care for as many as 200,000 Virginians, primarily by better coordinating care to which they are already entitled. But the number of people newly entitled to health-care coverage will be a small fraction of that.
McAuliffe said the state would enroll 20,000 people who are severely mentally ill in Medicaid, the federally funded health-care program for the poor and disabled.
The state would also provide insurance to 5,000 children of low-income state employees, though some of them — officials could not say how many — might have already had some form of coverage. A change in federal law under the Affordable Care Act authorizes McAuliffe to enroll those children into federally funded health insurance, his aides said.
And the kicker:
As he detailed his plan to hundreds of supporters on Capitol Square, McAuliffe acknowledged that it failed to fulfill his promise to expand Medicaid under the Affordable Care Act — a goal he said he would continue to pursue.
The Governor’s effort is not without merit, and he still needs General Assembly approval to make his changes permanent (and paid for).
McAuliffe’s move, however, is a bow to reality. When Republicans took control of the Senate this summer, it changed the political landscape in Richmond. McAuliffe may still be learning the ropes as governor, but he is no dummy. Pushing for full expansion when he holds not so much as a beachhead in the General Assembly gave him little hope of sustaining a sweeping executive action.
If anything, he’s taken a page out of his old boss Bill Clinton’s playbook. Play small ball. You can usually win.
