The Republican legislature in Virginia and Democratic Gov. Terry McAuliffe have been in a stalemate over Medicaid expansion for months. McAuliffe has been pushing for the expansion and included it in his budget, the legislature has been fighting it and the impasse could end up shutting down state government in July. Or McAuliffe could
bypass the legislature and issue an executive order to direct the Medicaid agency to come up with a plan to take the Obamacare money and provide coverage to the 400,000 Virginians now in the gap.
Such a step by McAuliffe would be dramatic. It would be high-risk, possibly triggering a paralyzing political brawl with Republicans and, maybe, a legal one. It could be high-reward, allowing McAuliffe to seize victory on his marquee issue and ensuring Democrats the support of thousands of registered—and healthier—voters, even those in GOP territory.
Republicans would get something out of it, too: Struggling hospitals in their districts would see an infusion of cash. Their uninsured constituents would have access to health care. Better yet, Republicans could achieve all this without having to vote or without having to give up a powerful issue. They could still rail against Obamacare, telling the tea partyers who terrify them at nomination time that they’d done all they could to prevent it from spreading further.
Medicaid expansion is
polling well in Virginia (outside of one
"highly misleading" outlier). Just as compelling, the state's own Medicaid agency has
estimated expansion would save the state
$1 billion between now and 2022.
For the 400,000 people Republicans are denying coverage, and for the fiscal future of his state, it would be the responsible thing for Gov. McAuliffe to do.