Virginia: Say "No" to Medicaid Expansion and More Taxes!

By James S. Gilmore III
Governor of Virginia 1998-2002

Last week the unified Democratic caucus in the General Assembly, supported by a few “break-away” Republicans, is about to expand Medicaid in Virginia.  Governor Northam, backed by his Democratic caucus say they will block the adoption of the state budget unless Medicaid expansion is included in the budget. The common good is being held hostage to Medicaid expansion. If the General Assembly bends to this pressure, it will lead to continuing tax increases to pay for an ever expanding Medicaid  program, forever. Medicaid is a federally defined medical program. Once this federal welfare program is enacted, our elected representatives will lose future control of the tax money Virginia must spend to support it.  
We all want citizens and children to have good healthcare.  The question is whether a government healthcare program paid for by the taxpayers should be the solution, or whether innovative ways to engage private insurance should be sought.
Once a government welfare program is given it can never be taken back.  The obligation of Virginia taxpayers will be permanent for this expanded program.  Virginia already includes 1.3 million citizens in the program. Already Medicaid expenditures take up 22% of the state’s general fund, more than one out of every five dollars.  This proposed expansion will increase participation by an estimated 300,000 to 400,000 people immediately, with giant cost increases the taxpayer will have to fund out of what’s left of the budget.  
The demand for free healthcare is infinite and so will be the rising costs. The requirement to appropriate taxpayer’s money to fund this Medicaid program is not limited by any ceiling.  Obamacare promises that the Federal government will pay 90% of the cost of the enormous cost increases incurred due to the expansion, “It’s those stupid federal taxpayers who will be paying the bill”, they say.  Still, the Virginia taxpayer will pay 10% more for the program, permanently, the dollar amount of the 10% obligation will continue to rise, and we are all federal taxpayers too.
Those who seek this expansion use a “blackmail” argument. They say the federal tax money we Virginians pay is going to fund other states that gave in to Obamacare and expanded their Medicaid programs.  I say our Senators and Congressmen should be reforming the national program to make sure the portion of our federal taxes going to the Medicaid is returned to the state paying it.  No state should be forced to expand its Medicaid obligations in order to receive back the taxes its own citizens have been forced to pay.
The Medicaid program has no flexibility.  Elected officials will have no say over that tax money coming from our taxpayers. When I was governor, I submitted balanced budgets each year to the General Assembly.   Elections are always about new directions. Every governor has his own priorities and programs he or she wants to offer. The inherited budget must be adjusted to find the funds to finance any new initiative.   Every year I looked at the giant spending that was in the budget for Medicaid. Every year I was told no savings were possible because it was a federally mandated program that Virginia had accepted years before.  That Medicaid money was “off the table” in drafting the next year’s budget.
When I phased out 70% of the car tax in Virginia during my four years as governor, the next General Assembly, and Governor Mark Warner refused to continue the car tax phase out, as they had promised.  The car tax rebate was “capped”, and this is why we still pay an ever rising portion of the car tax today. Over the last sixteen years the state budget has nearly tripled, and not one dime of additional car tax relief has been appropriated to finish the phase-out of the car tax.  Yet the General Assembly now intends to adopt a Medicaid expansion that can have no ceiling. The costs will continue to rise forever, squeezing out fundamental needs like education, public safety, higher education, and other essential needs. They say car tax relief must be stopped, but government spending on health care must be a never ending rising obligation of the Virginia taxpayer.  When future tax increases are proposed to meet these increased obligations,  the excuse will be that we need more money for education, transportation etc.  The money we tax to fund those priorities will be gone to an increasing Medicaid cost, and will have to be made up from new tax increases. If the Congress ever alters or abolishes Obamacare and limits the reimbursement to the state, Virginia will be raising taxes even more to pay for this expanded Medicaid program.   
Our federal and state legislators should be finding ways to reform insurance policies to make more choices available to people of modest means.  Today, the insurance industry increasingly competes with the government with its taxpayer flood of money. No wonder innovation solutions can’t be found for the availability of insurance.
It’s time for new solutions to health care besides the government defined Obamacare.  Expansion of Medicaid shoves us through the door of the government solution, and locks the door behind us.  Continuous tax increases to fund this program are ahead if the General Assembly takes this action this week. The General Assembly should say “No” to Medicaid expansion and send a clean budget to Governor Northam for his signature.   Read more at Jim Gilmore

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