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We fuel progress around the world.
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Free the
Budget Hostage
By Delegate James P. “Jimmie” Massie, III
Republicans do not believe that the state
budget should be held hostage for immediate
Obamacare Medicaid expansion!
Republicans do believe it is a core
essential service of government to help those
who absolutely cannot help themselves.
Virginia’s existingMedicaid program covers some 1millionVirginians,
it is the largest line item in the state budget at $9ish billion per year and
will receive 40% of all new revenue or $600 million.
Republicans also know that our existing Medicaid program is
unsustainable. It is currently 22% of the General Fund, it is growing at
8% per year when our revenues are growing 4%. And it is fraught with
25 to 30 percent waste, fraud and inefficiencies.
House Republicans are very concerned about Medicaid expansion
for three reasons. First, we are very concerned about the private option
proposed by the Senate in their budget. The private option has never
been tried before. The private option CMS waiver would be for only 3
years and then we would have to renegotiate.
Second, the federal government’s financial guarantee to pay 100%
of the costs for 3 years and then scaling down to 90% thereafter….
forever. Currently the federal government is over $17 trillion dollars in
debt. Additionally, it spends approximately $90 million per hour more
than its revenues. This means the federal government has to borrow
approximately $430 million per hour, 24 hours a day and 365 days a
year just to refinance its existing debt and pay its current bills. Given
this, the federal government is most likely not going to be able to keep
its commitment to pay 90% of the Medicaid expansion costs forever!
Third, I find the assertion that in 3 years Virginia could just cancel
the expansion, if the private option wasn’t working or even more likely
the federal government wasn’t meeting its 90% financial guarantee to
be suspect at best. When was the last time any government took back
an entitlement to hundreds of thousands if not millions of its citizens?
All this uncertainty, the magnitude of the decision, and the current,
huge problems with Obamacare cry out for a go slow, circumspect
approach to Medicaid expansion. That is, do not hold the budget
hostage in exchange for immediate Medicaid expansion. Let the
Medicaid Innovation and Reform Commission, which was created via
a bipartisan vote during our 2013 Session, work and have a Medicaid
only special session probably in the fall.
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