Virginia Gov. McDonnell feeling pressure on Medicaid

Gov. Bob McDonnell Virginia's Bob McDonnell is one of just a few Republican governors left to have not yet decided whether his state will accept Medicaid expansion funding from the federal government under the Affordable Care Act. And he's feeling the pressure as he weighs the decision, because Democrats in the state legislature are using their leverage.

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.

As in every other state, the business and health care communities are also pushing for the expansion because it makes sense for the state's economy. More people with guaranteed health coverage means more people getting affordable care, more health care jobs, a healthier population, and much less uncompensated health care for institutions and the state to have to cover. It's 300,000 people getting coverage at significant cost savings for the state.

Put aside the extreme ideology, and it's an easy decision. Particularly for a Republican governor in a state that isn't purple or blue who's thinking about reelection.