Letter to Governor McAuliffe | Council For Citizens Against Government Waste

Letter to Governor McAuliffe

Letters to Officials

June 19, 2014

The Honorable Terry McAuliffe Office of the Governor
1111 East Broad Street Richmond, VA 23219

Dear Governor McAuliffe,

On behalf of the 35,289 members and supporters of the Council for Citizens Against Government Waste (CCAGW) in the Commonwealth of Virginia, I ask that when you sign the budget that was passed on June 12 by the General Assembly you do not strike the section of the budget that blocks Medicaid expansion without approval of both houses of the General Assembly.

The relevant provision states, “notwithstanding any other provision of this act, or any other law, no general or non-general funds shall be appropriated or expended for such costs as may be incurred to implement coverage for newly eligible individuals pursuant to 42 U.S.C. § 1396d(y)(1)[2010] of the Patient Protection and Affordable Care Act, unless included in an appropriation bill adopted by the General Assembly on or after July 1, 2014.” While it is not clear whether the governor has the authority to strike this language, what is clear is a line-item veto of this provision will lead to a budget showdown with the legislature and a possible government shutdown, something you promised Virginia taxpayers you would not do.

An April 2014 poll conducted by the Wason Center at Christopher Newport University found that 53 percent of Virginia voters are opposed to Medicaid expansion while only 41 percent are in favor. Expanding Medicaid as provided for under Obamacare is a bad idea; Medicaid is a terribly flawed program that delivers subpar care at excessive cost to state budgets. A survey by the physician staffing and consulting firm Merritt Hawkins shows that less than 50 percent of physicians are accepting patients insured by Medicaid. In addition, two studies of emergency room visits released in 2014 found people on Medicaid increased their utilization of expensive emergency room treatment; contradicting the argument that Medicaid expansion would reduce such venues of care. The first of the two studies, published in the January 17, 2014 edition of Science Magazine, was undertaken in Oregon where Medicaid was expanded under a 2008 lottery system. The second, conducted in March 2014, was a survey of emergency room doctors carried out by the American College of Emergency Physicians.

Furthermore, with a rising $17.6 trillion debt, it is unlikely that the federal government will keep its promise to continue to fund Medicaid at 90 percent. In fact, President Obama already proposed lowering the federal government’s Medicaid contribution during the 2012 “fiscal cliff” negotiations. Plus, the Congressional Budget Office announced in April that it can no longer score various aspects of Obamacare and its impact on federal revenue and deficits, which should send a red flag to all state governments thinking about expanding Medicaid.

An independent study, released in December 2012, by Chmura Economics & Analytics found that expanding Medicaid in Virginia will cost the state about $589 million annually by 2020. That cost could rise to nearly $2 billion a year if the federal government backs away from its pledge to pay for 90 percent of the programs cost. The state already has a projected budget shortfall of about $1.6 billion due to lagging revenues. While the budget on your desk helps to close that gap, expanding Medicaid would be fiscally unwise.

Instead of trying to find ways to work around the legislature to expand Medicaid, a gesture that will engender mistrust and contribute to a highly partisan atmosphere for the rest of your tenure, I urge you to give the Medicaid Innovation and Reform Committee the time to find the healthcare policy solutions that will work best for Virginia.


Thomas Schatz  


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