Mullins op-ed: Fix Medicaid before expanding it

By Pat Mullins

Terry McAuliffe has made Medicaid expansion a central pillar of his campaign. Virtually all of his ideas involving increased spending revolve around it. Indeed, his entire policy agenda falls apart without it.

Terry McAuliffe likes to talk about the “free” money that will come rolling into Virginia, thus enabling him to pay for all the unicorns and rainbows he’s been promising out on the campaign trail. But, that “free” money comes with a price tag — $283 million that the Commonwealth will have to pony up as its match.

And that $283 million will come from somewhere — either schools, roads, law enforcement, or higher taxes. I spend a lot of time in Richmond, and I’ve yet to see any piles of cash just lying around the Capitol or General Assembly building. We have no guarantees that the money from Washington will keep flowing, either.

Liberals don’t mince words on this issue. They say Republicans are heartless. They say we don’t care about the disabled, or that we want children to suffer with disease. Sadly, that’s what passes for reasonable discourse in Democratic circles these days.

Of course Republicans want everyone to have health care. But we want to be sure the most vulnerable have a safety net and we have very different ideas about how to ensure that everyone has an opportunity to access affordable health care.

Most Republicans would have preferred a free-market solution: for example, letting people buy plans across state lines, so they can find the coverage that meets their needs. Doing so would give consumers more flexibility, and encourage competition. And as we’ve seen time and time again, competition brings down prices for consumers.

But the Democrats in Washington insisted on ramming ObamaCare through with no GOP support, taking the idea of competition off the table. We have a way of doing things differently in Virginia. We work together to accomplish a common goal.

Earlier this year, Republicans and Democrats in Richmond found a way forward that everyone can live with: leave the door open to expansion, but then and only then, after the program had undergone major reforms that would let Virginia, not Washington, decide how to run the program.

It’s a simple idea: let Virginia make significant changes to cut out waste, fraud, and abuse, makes some reforms that improve the quality of care delivered, and then we can talk about making the program bigger if it is financially prudent and feasible to do so. Those who argue that the federal government is better at managing programs than Virginia simply live in a dream world.

So why is expanding Medicaid without reform a bad idea? One, simple, irrefutable fact: we can’t afford it.

One of Congress’s favorite tricks is to encourage states to start a program and offer free money for the first few years to pay for it. Eventually, the money runs out, but the program doesn’t. Washington, D.C., is broken. As we’ve seen over the past two weeks, the Federal government can and sometimes does shut down. What’s to say that some future dispute over funding in a dysfunctional Congress won’t hold up the money for Medicaid to states?

Suddenly Virginia’s bill goes up from $283 million to more than $1.4 billion per year. I’m not an economist, but I’m fairly certain that would make a sizable dent in the state’s budget. It would be like buying a house with a balloon mortgage payment. Accepting such a burden would throw the state’s finances into chaos, and possibly even cost the Commonwealth its “AAA” bond rating.

Even worse, those individuals who need the safety net, the most vulnerable, sickest patients, would not get the care promised to them.

Ken Cuccinelli knows better than anyone else how badly flawed our current Medicaid system is. His office investigates and prosecutes Medicaid fraud. That’s just one reason he’s so adamant that the system be fixed before we pour hundreds of millions into it.

Virginia has always had a sterling reputation for financial management. Maintaining that reputation means making smart, long-term decisions. Terry McAuliffe promises everyone they can have their dessert first. Ken Cuccinelli knows we must fix Medicaid before we expand it.

Like I say every week, it’s not a difficult choice. Vote for Ken Cuccinelli on November 5th!

Pat Mullins is chairman of the Republican Party of Virginia

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