McAuliffe on Medicaid expansion: ‘I and I alone will take responsibility’

RICHMOND — Virginia Gov. Terry McAuliffe unveiled a two-year pilot program to expand Medicaid coverage for up to 400,000 Virginians through President Obama’s health care overhaul Monday — a move immediately rejected by Republicans on Capitol Square and one that portends another showdown that could stretch into summer.

The specifics of the proposal are partly a nod to Republicans wary of the federal government’s ability to pick up the bulk of the program’s cost over the long run.

But they also allowed Mr. McAuliffe to take ownership of the budget process after lawmakers were unable to agree on amendments to the two-year blueprint left by his predecessor, Republican Bob McDonnell, during this year’s regular 60-day session that ended earlier this month.

“If expansion doesn’t help our people, then I and I alone will take the responsibility,” Mr. McAuliffe said. “So when people say, ’What happens in two years if we don’t continue the program and we have to knock folks off?’ Let every camera have it clear that it was the governor who will take full responsibility, so everyone else is off the hook.”

Mr. McAuliffe’s new two-year, $96 billion budget uses the estimated $225 million in net savings to fund a 2 percent salary increase for state employees and teachers, including college and university faculty, as well as millions in new investments in health care, the state retirement system, education, and other items.

In his presentation, Mr. McAuliffe waved a letter from the Centers for Medicare and Medicaid Services (CMS) for emphasis, saying it is proof positive that Virginians won’t have to stay in the program if they don’t want to.

Under President Obama’s health care overhaul, commonly referred to as Obamacare, Washington picks up 100 percent of the costs associated with expanding Medicaid to certain individuals making up to 138 percent of the federal poverty level, which in 2014 is $23,850 for a family of four. That subsidy eventually winds down to 90 percent.

Republicans, however, reiterated their position that Medicaid language should be separated entirely from the budget process and that the issue should be dealt with at a later date. The House Appropriations Committee voted Monday to pass by Mr. McAuliffe’s budget indefinitely.

“This is all about leverage,” said House Majority Leader M. Kirkland Cox, Colonial Heights Republican. “This is all about something where they cannot get a standalone piece of legislation. So they’re willing to hold up an entire state budget … and we said it over and over and over again, ’That’s your schoolteachers; that’s your public safety personnel.’”

For its part, the Virginia Education Association offered praise Monday for the governor’s proposal.

“We congratulate the governor for recognizing the needs of children as a priority, and we call on members of the General Assembly to follow his lead,” said VEA President Meg Gruber.

Senate Democrats — with the help of several Republicans — did push through a plan during the regular session dubbed “Marketplace Virginia” that would use about $2 billion of federal Medicaid money a year to allow a quarter million residents in the state to acquire insurance through the private market.

In a letter to lawmakers who were returning from a two-week break from the end of the regular session, Mr. McAuliffe praised the Marketplace Virginia effort, but noted that he has remained attentive to concerns from the House GOP on “the dangers of the federal government irreversibly locking us into a decision.”

“Now, with CMS’ explicit confirmation that we would face no such challenges, there can be no more excuses,” he wrote.

If lawmakers do not agree on a new spending plan by July 1 — the start of the new fiscal year — they run the risk of the state government shutting down.

Senate Minority Leader Thomas K. Norment Jr., James City Republican, said the governor made a “very interesting and intriguing presentation” but that Mr. McAuliffe made another “freshman misstep” with what Mr. Norment called a confrontational tone.

“I think he’s still getting settled in learning about governance,” he said.