McAuliffe’s salvo on Medicaid expansion

Virginia’s vaunted business community has presented its economic “blueprint” to Terry McAuliffe and, naturally, it seeks to have the government (and taxpayers) do more for business:

Among those recommendations, the chamber wants the state to put more resources into early childhood education, and put more emphasis in public schools on preparing students for skills needed in science, technology and health care careers.

Barry DuVal, president and CEO of the state chamber, said he expects legislation to be introduced during the next General Assembly session to address many of the chamber’s proposals.

“We are going to be looking at initiatives to get private industry more involved in education and workforce preparation,” DuVal said. “We are going to be supporting initiatives to better align the education system to the needs of employers.”

So much for the once prized liberal arts education.

Not that one should expect anything less from a chamber of commerce. But as a rejoinder to this wish list, McAuliffe made a request of his own:

“Growing our economy and strengthening our workforce will remain an uphill battle as long as 1 million Virginians remain uninsured,” he said.

“Let me be clear on one point, if Medicaid expansion is not the business community’s No. 1 priority in your communications with the General Assembly … it will not happen,” McAuliffe said.

Recall that candidate McAuliffe said he would shut down state government unless the General Assembly expanded Medicaid:

His campaign tried to walk that back a bit, but McAuliffe’s most recent remarks show that he has absolutely no intention of backing down on the matter and seeks to dragoon the business-types into his service.

He has a fair chance of doing so, largely because McAuliffe linked greater spending on the education programs the Virginia Chamber prizes to Medicaid expansion.

And it is also likely McAuliffe will have Republican support for expansion — in the Senate. Sen. Emmett Hanger, for one, is all for expansion. But this being Emmett, there’s always a twist worth noting:

Earlier in the discussion, Senator Hanger pointed out that he disagrees with the name “Obamacare.”

“That politicizes it too in my mind in terms of calling it the name of a president, so I think we should focus on the need for affordable healthcare,” said Hanger


With worthies like Hanger in office, Mr. McAuliffe’s opportunity to swing a Medicaid deal are real, ripe and waiting to be picked. The House is, supposedly, unwilling to do so under any circumstance. We shall see whether that resolution holds…and whether we are courting the possibility of a replay of the epic 2004 battle between the House and Senate.

  • midwestconservative

    And if he can’t get the GA’s approval he can always do what John Kasich did and expand it via State Board of something or another.

  • Jim Portugul

    To not expand Medicaid in Virginia is just partisan politics. The Federal Government will pay 100% of the cost for the first 3 years, and 90% thereafter.

    To keep this money out of Virginia is just plain wrong. Like any other business, volume lowers cost, the same is true in healthcare. Expanded Medicaid should increase volume, and lower costs.

    Most people do not realize that allowing Wall St. to export our jobs overseas is one reason we have higher healthcare costs. This being due to the lower volume this created.

    The taxpayers put Gov. Elect McAuliffe in the Governors mansion to do just what he is going to attempt to do.

    Our government is majority based rule.The majority spoke on November 5.

    • Markos_Anderson

      Yes, by voting in a GOP majority in the Virginia State House.

    • NormLeahy

      So McAuliffe got 47 percent of the 43 percent of voters who went to the polls. By your definition of majority based rule, he has the backing of a very small minority of Virginians.

      What we actually have is a republican form of government, which is quite different than majority rule.

    • MD Russ


      While I agree that Medicaid needs to be expanded, your economics of volume lowering cost is flat wrong. Go look at the exponential increase in health care costs since Medicaid/Medicare were introduced in 1965 versus the cost increase curve from 1945 to 1965. It is a big eye-opener. When medical care is free or subsidized, people use much more of it and health care providers encourage them to do so. Volume, in the case of health care, does not lower costs overall. It dramatically raises them. A heart surgeon, for example, cannot perform a by-pass operation cheaper by doing three of them a day instead of one. The good news is that the increased life expectancy curve over the same periods is almost as dramatic. We have gone from a life expectancy at the beginning of WWII of 65 to one today of 78. But don’t think that increased life expectancy comes without a significant cost. Health care now consumes about one-sixth of our entire GDP and Social Security and Medicare benefits for retirees now consume the payroll taxes of four workers to support one beneficiary. And that ratio is increasing geometrically. It really makes the case for entitlements reform, doesn’t it? Like raising the retirement age for SS and means-testing all benefit programs just as Medicaid is means-tested.

      BTW, Norm. The Chamber is looking at the wrong segment of the population when they want government to improve education for pre-school and K-12 students. The real education shortfall is right under their noses–their existing employees. A recent study released by the National Center for Education Statistics (NCES) shows that working adults in the US fall far below their peers in other industrialized countries in job skills. When working Americans are stratified by age group, only the oldest groups who are nearing retirement come close to meeting the international median. The implications of this, coupled with the need to redeploy workers to new production sectors, is very obvious.

    • Craig Scott

      A plurality voted for T-Mac, not a majority. A plague on
      both parties, the taxes were pushed through with the Dems plus statist
      Republicans. Medicare is an additional statist narcotic removing market vigor,
      while bankrupting the country, yet another Federal hook on Virginia. Remember
      the commonwealth as with other states are already saddled with over 20% of its
      / their budget(s) with Federal mandates of empirically failing/failed programs
      or cronyisms. You want to help folks afford any service, medical, whatever,
      then lower their taxes, to keep the fruits of their own labors and not edicts
      from on high.

    • D Guest

      Maybe lower cost per patient, but higher coast overall! Your argument about volume makes no sense. Except more money for the well-financed hospital lobby.
      Why would we want to spend more Virginia dollars overall when our (taxpaying) people are mostly taxed to the hilt and our country is in a debt crisis?

  • Jim Portugul

    Why anyone would even consider rewarding the Republicans for the largest tax increase in Virginia history is beyond comprehension. Not to mention the runaway spending in the previous McDonnell/Republican budgets. The Republican led budget increases were 3-4 times the cost of living index.

    Now, then there is gift gate, and the possibility that McDonnell and Cuccinnelli may end up as cell mates?

    Then, there is Obenshane, who spent almost twice as much money (some of it Koch money) as Herring, and may still lose the AG race.

    If I see Koch money as money in for a candidate at The VPAP website, I vote for the other candidate.

    • MD Russ

      What if the VPAP web site shows that the other candidate has money in from George Soros?

    • Not Harry F. Byrd

      “Jail cells” “Largest tax increase” and “Koch money”. Nah, you’re just a fair minded moderate observer…

  • Jim Portugul

    Russ, notice that I used the word “should” lower the cost.

    The surgeon cannot, or will not, lower the per procedure cost if doing 3 instead of 1 per day?

    But, how about the machines required, and keeping the hospital beds full? If the machines are not sitting, doesn’t the cost become less per procedure done? In other words, if you do three a day using the same machine, the per use is lower for all three. Is the per patient cost cheaper for a full hospital, or one half full? If billing bills for three a day instead of one, is that cheaper? Does administration also get cheaper with more patients ? How many people are on drugs that they do not need?

    Then there is corruption. Now if you are talking about corruption in the industry? How many tests and procedures are being done that are not necessary? How much billing is being done for things that were not done?

    Campaign finance reform will be necessary to stop that. To much money from healthcare PAC’s is being pumped in to political PAC’s to get Congress to do anything.

    Where there is money, there is corruption. Wall St. and Washington are corrupt beyond imagination.

    Now, why do you suppose the deductibles are so high with ObamaCare? Could it be to discourage one from going to the doctor unless necessary? Cut demand with high deductibles, and won’t that lower the cost.

    As far as my ObamaCare plan, I would not go to the doctor unless I absolutely had to. Cost to much. By the way, the website worked for me 7 days after it opened. At my age, ObamaCare is far cheaper than without.

    Anything that Corporate America hates as much as ObamaCare just has to be good for the middle-class.

    • midwestconservative

      Those “evil” insurance companies love Obamacare. They helped push it through Congress. Your populism is misplaced.
      But good for you, The ACA has helped you, one of the few. At the expense of me and countless other young people who are also going to get screwed by student loans. But I’m glad I can make an old-timer like you comfortable.

    • isophoroneblog

      I don’t know that the ObamaCare plan is “cheaper” if the deductibles are that high. You also don’t mention how many doctors and hospitals can really be accessed under your “cheaper” plan, and what kind of penalty you pay if you go to an out of network health care provider.

    • D Guest

      So with the high deductibles, it’s almost like you don’t have insurance. You may be able to afford that, but families can’t, especially with the higher premiums for the younger folks who are just trying to gain a foothold and start families. And if you don’t go to your doctor, by the time you think it’s ‘necessary,’ it may be too late and necessitate stronger treatment if possible.
      Not to mention that often the better medical centers are dropped from the Obamacare plans.
      So it’s now de facto catastrophic but at a higher premium. A better choice would be allowing true catastrophic and expanding HSAs, instead of placing all these restrictions on all of us and denying freedom of choice. I would gladly pay more in taxes also to help just the people who truly can’t get insurance while leaving the rest of us alone.

    • JBluen

      Who says corporate America hates Obamacare? They love it because it allows them to dump employees onto the exchanges. Why do you think Obama got so much campaign cash from corporate donors?

  • Jim Portugul

    D Guest, the thing to do is to call your Republican Rep, ask them where is their plan?

    What we have now is the result of a political party that has talk radio hosts for leadership.

    Until Corporate and special interest money is thrown out of Washington, and Richmond, nothing will change for the better.

    The healthcare industry and Republicans still think they will eventually win. as long as they control the corporate owned media.

    It’s not about right or wrong, Democrat or Republican, left or right. It’s about money!

  • Jim Portugul

    D Guest, lower cost per patient should mean lower cost overall. Unless, of course, there is corruption. Stop the corruption.

    Put people in jail. Providers have been crooked for years with there creative billing. That is why we have what we have now.

    I had a conversation yesterday. A friend who spent 28 hours in the hospital. Just the hospital bill. $51,000.

    Nothing but a racket. The resistance to ObamaCare is Corporate. They do not want to give up our money, they want it all. Ask someone in Congress how much tax does the healthcare industry pay?

    The real savings will be ObamaCare Part 2. Part 2 will stop some of the Corruption.

    Do not be fooled. If the other 32 industrialized countries can have affordable Universal healthcare, SO CAN WE!

    That is right, we are the only one of the 33 industrialized counties on planet earth that does not have Universal healthcare. Did Beck, Limbaugh, or Hannity, tell you that? Guess it must have slipped their mind?

    Oh, and if we have a spending problem. then why don’t they stop spending? Bernanke is pulling $85 Billion a month out of thin air, called QE, and sending it to those who need it least. Wall St. Banks. NOT BORROWING, CREATING, OVER A TRILLION $$$$ A YEAR!

    Then we accuse the Chinese of manipulating their currency. Go figure.

    The entire food stamp program is about $80 Billion a year. What a joke this country has become!

    And just think, just 13 years ago, Democratic Pres. Bill Clinton left George Bush a budget surplus.

    What did President Bush leave President Obama? One hell of a mess. Look what McDonnell is costing the taxpayer in legal bills, not to mention the tax increase. Another hell of a mess for someone to have to clean up.

    Why doesn’t the Tea Party fight Corporate Corruption? Because they are the facade for Corporate Corruption!

  • Jim Portugul

    MD Russ, fair enough question.

    George Soros shows only one donation, Tim Kaine in 2005, $40,000.

    Now, let’s look at Koch Industries. VPAP shows registered lobbyist for Koch Industries in Virginia. Total Donations, almost $682,000. Now who do you think is buying influence?

    From the looks of it, The Koch’s have Speaker Howell, McDonnell, Cuccinnelli, on their speed dial list, along with the Republican Party.

    Stop drinking the kook aid my friend, turn off the radio.

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