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GOP Resistance to Medicaid Expansion Cracks

Medicaid expansion is coming to Virginia. All legislators are dickering over now is their price for making it so.

Sen. Frank Wagner (R-Virginia Beach) said [1] he’s willing to expand Medicaid if his conditions are met.

Meanwhile, Sen. Emmett Hanger (R-Augusta) stiffened his support for expansion. In an op-ed [2], Hanger wrote he had “no intentions of voting for a final budget that does not include a plan to access the additional dollars that are available to us currently under Medicaid.”

Let’s add to the mix Sen. Jill Vogel (R-Fauquier), the GOP’s lieutenant governor nominee in 2017, who hasn’t ruled out voting for expansion.

And for good measure, we can add a weekend op-ed [3] from former senator Jeff McWaters, who wrote that once congressional Republicans failed to repeal Obamacare, Virginia Republicans had little choice but to draft an expansion plan of their own.

Even with all these cracks in the Republican façade, Senate Republicans insist [4] they will prevail in the expansion fight.

The Senate Republican leadership’s press release [4] on Wagner’s proposal shows they’ve already lost.

They call Wagner’s plan “well-intentioned” but “neither well-conceived nor well-designed.”

That’s a gentlemanly way of casting shade and admitting he’s left the anti-expansion fold.

But one of the biggest outside players in the Medicaid debate, the Virginia Hospital and Healthcare Association, isn’t ruling out Wagner’s idea.

Julian Walker, the group’s vice president of communications, told me Wagner’s proposal “identified a critical issue facing Virginia families and businesses today – the ever escalating growth in health insurance premiums.”

“This is a true kitchen table, quality-of-life issue for Virginians,” Walker said.

Walker argues the data show the big cost drivers aren’t doctors or hospitals, but individual health insurance premiums, which he said have risen “between 34 percent and 81 percent.”

“We look forward to working with Senator Wagner to address this incongruity,” Walker said.

Perhaps more importantly, especially to someone like Hanger who has staunchly opposed assessing hospitals to help pay for the state’s share of Medicaid expansion, Walker said that while the VHHA has “traditionally opposed the provider assessment concept, Virginia’s hospital community is willing to consider an assessment in an effort to support a compromise on coverage expansion.”

Continue reading here [5].