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House GOP Debates Medicaid Expansion Rejection Methodology

February 7, 2014

By James K. Galloway
Capital News Service

RICHMOND – House Republicans are echoing national GOP rhetoric in rejecting the Medicaid expansion, strongly backed by Democratic Gov. Terry McAuliffe.

Delegate James “Jimmie” Massie, R-Richmond, said Obamacare could likely “implode.” Massie said he handles the “business side” of Medicaid reform.

“I would say (it’s not going) particularly well so far,” Massie said with a laugh. “My opinion is if you think Obamacare was hard signing up for on the website … wait till you try to use it.”

Massie is a member on the Medicaid Innovation and Reform Commission, the committee tasked with reviewing and recommending reform proposals affecting the Virginia Medicaid and Family Access to Medical Insurance Security programs.
Massie said federal government inefficiencies lead to fraud and waste, which compromise up to 30 percent of its budget — a statistic he says he believes would increase if Medicaid is expanded in Virginia.

“If we do anything in the state of Virginia,” Massie said, “it’s going to look like private options. In other words, we’re going to take the money from the federal government that will allow these uncovered people to buy their own health insurance.”

Massie said Medicaid is abused because people go to the doctor with their Medicaid cards, and let the doctors do whatever needs to be done:

“I have no equity in the decision — no financial incentive to do the right thing, on controlling what you do to me, how much of it that you do, what it costs — much less, my health — taking care of my own self,” Massie said.
Massie also said studying other states could help the MIRC decide how to react to Medicaid expansion in McAuliffe’s budget proposals.

Arkansas and Iowa, for example, have not gone along with the government management of Medicaid expansion. Those states instead offer a “taxpayer recovery fund” that is supposed to grant federal money to the uninsured so they can afford to pay into private insurance plans.

Sen. John Watkins, R-Midlothian, proposed a similar taxpayer recovery fund, calling it a “pro-business, common sense solution.”

Massie said he was not familiar with the specifics of Watkins’ proposal.

The split in opinion hinges on a disagreement of whether or not to take any federal funds, which must be debated once a House budget is proposed.

Speaker of the House William Howell, R-Fredericksburg, said Watkins’ proposal — which still has not passed the finance committee — is Obamacare’s Medicaid expansion by another name.

“Medicaid and Obamacare expansion are poisonous words,” Massie said. “So (Watkins is) messing with the semantics, or he’s trying to get the right semantics right to create a pass.”

Massie said “private market incentives” will prevent the public from abusing the healthcare system.

“(People) are going to have to pay some money for the coverage,” Massie said. “They’re going to have co-pays. They’re going to have rewards for healthy living. They’re going to have work requirements — and work search requirements.”

Massie says the Republican Party’s proposal will incentivize the public to make healthy choices and good business decisions when choosing insurance.

“Not just ‘I don’t care. I go in. Give me everything,” Massie said, “because it doesn’t cost me anything.’”

A House budget must be produced containing each proposal to be debated against McAuliffe’s submitted budget plan.
Massie said the MIRC is looking for “the Virginia way.”

“If we find ‘the Virginia way,’” Massie said, “it’s going to look a whole lot more like private market insurance, rather than Medicaid.”

Watkins did not respond to requests for comment.