VIRGINIA

ANALYSIS: Terry McAuliffe's Medicaid expansion crusade seems ill-fated

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(WJLA) – When new Virginia Gov. Terry McAuliffe addresses the Virginia Hospital and Healthcare Association Legislative Issues Conference early Wednesday afternoon at Richmond’s stately Jefferson Hotel, the occasion will more or less resemble all those campaign stops last summer and last fall, where the crowds readily agreed with -- and roundly applauded for – his platform, front of center of which was Medicaid expansion.

“Yes”, says Katharine M. Webb, senior vice president of the aforementioned organization, “the Governor will have many friends in his audience on Wednesday.”

That’s largely because McAuliffe wants to accept federal money to expand Medicaid offerings throughout the state, something the VHHA roundly supports. But the big difference between this gathering and those on the stump is that while the latter ultimately resulted in success for the supporters, the former almost certainly will not.

Despite McAuliffe’s best back-room, let’s-have-a drink efforts in trying to woo Republicans from the GOP-controlled House of Delegates into even gingerly coming around to his way of thinking on Medicaid expansion, no dice.

Webb calls that lamentable.

Larry Sabato calls it predictable.

Sabato is the head of the University of Virginia’s Center for Politics, and he is nothing if not blunt.

“Nothing pumps up the GOP base,” he says, “like Obamacare this year.”

But this is about Medicaid expansion. Not so much about Obamacare.

“Medicaid expansion is closely associated with Obamacare,” Sabato says. “The Republican base is virtually united in opposition to Obamacare, and the GOP nationally is focusing tightly on the subject for the 2014 midterm campaigns.

“Virginia's House of Delegates is two-thirds Republican, and they are listening to their party's activists.”

For example, here’s this from the Associated Press: “. . .(Our) spines are strong and we’re going to stand for freedom here in the commonwealth of Virginia and say no to Medicaid expansion,” Del. Ben Cline, R-Rockingham, recently told a small crowd organized by the tea party group, Americans for Prosperity, gathered at the Capitol for an anti-Medicaid expansion rally.”

Former Gov. Bob McDonnell often cited his doubts that the federal government would make good on its commitment to cover most costs associated with expansion.

Nonsense, said the Washington Post editorial board Monday, writing that helping approximately 400,000 Virginians in need, and possibly even coming up with some sort of state-exchange compromise used with mixed success in other states is better than nothing: “(If) these plans are the easiest paths for leaders in red or purple states to overcome GOP opposition, we welcome them.”

And consider part of the pitch from Virginia’s branch of the AARP: “Providing health insurance coverage to nearly 400,000 Virginians – including 62,000 between the ages of 50–64, is once again before the Virginia General Assembly. We need your voice to bring Medicaid health care coverage to those who need it most, including thousands of military veterans who are currently denied access to health care.”

That’s the choir McAuliffe has been preaching to.

This, though, is politics.

“Apart from the policy debate -- Republicans claim Medicare expansion would backfire and spiral out of control once the feds stop paying their current share -- there is the political calculus,” Sabato says. “A midterm election has lower turnout, and it is base v. base.”

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