Could Virginia Dems Force Gov. McDonnell To Embrace Obamacare’s Medicaid Expansion?

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If you’re wondering whether any conservative governors will seek cover under John Kasich’s decision to embrace the Affordable Care Act’s Medicaid expansion, check out what’s happening in the Virginia legislature.

Virginia Democrats, who control half the seats in the state’s Senate, are threatening to derail Gov. Bob McDonnell’s key legislative priorities unless the new state budget expands Medicaid unconditionally.Democrats’ leverage is somewhat limited. But among other priorities McDonnell is keen to designate nearly $50 million in sales tax revenue for transportation projects. Democrats hope McDonnell’s desire to lock in those accomplishment before his term comes to an end will convince him to relent and agree to avail the state of federal funding that would expand the Medicaid program to cover people up to 133 percent of the federal poverty line.

The existing language calls for expanding Medicaid, but only contingent upon the state adopting measures to contain the growth of spending on the program. Both the House and Senate drafts would require future legislative action for the expansion to occur. The House budget retains for Virginia the option of dropping out of the expansion if federal funding decreases in the future.

Senate Democrats, still furious about an mid-decade redistricting plan Republicans muscled through the Senate on inauguration day last month, think they can stick together to oppose the budget amendments unless Republicans agree to remove strings from the Medicaid expansion. All five Democrats on the Finance Committee voted against it. They have a degree of implicit support from Lt. Gov. Bill Bolling (R ), who also backs the expansion. Bolling lacks the authority to vote on the budget, but he may be speaking for less conservative Republicans in the assembly who may be wiling to negotiate. And though a similar legislative tactic failed last year when a Democratic senator defected, this year the threat of a government shutdown has been removed. What’s at stake now are McDonnell’s priorities, along with measures both parties support — and Democrats think that gives them power.

“The chances of them holding this are actually pretty good,” says Ben Tribbett, a Virginia state politics blogger and Democratic consultant.

He cautions, though, that the real prize for Democrats isn’t the Medicaid expansion, but the possibility that they could use the threat of a budget stalemate to convince McDonnell to deep six the redistricting plan — even if that means the Medicaid expansion remains imperiled.

According to The Virginian Pilot, which explains other moving parts in this process, Democratic Sen. Kenny Alexander is the weakest link in the caucus. But a lot hangs on a Wednesday House vote on the redistricting plan. If Republicans pass it and McDonnell signs it, it will embolden Democrats to keep up the push on Medicaid.


Brian Beutler is TPM's senior congressional reporter. Since 2009, he's led coverage of health care reform, Wall Street reform, taxes, the GOP budget, the government shutdown fight and the debt limit fight. He can be reached at