Northam threatens (nicely) to use amendment to muscle in Medicaid & Thousands flock to free medical clinic, as Washington dithers on health care 2MAR18&21JUL17

Thousands flock to annual free medical clinic in Wise, Virginia , as Richmond dithers on health care

 
Whatever the Virginia assembly does with Medicaid expansion the legislation must stipulate it replaces the current health insurance for all members of the assembly, their staffs, all assembly employees as well as the governor, lt governor and their staffs. The taxpayers of Virginia, no matter one's income level, are the employers, these people are our employees and their health insurance program should not be any better than what they would legislate for the least among us who are also Virginia Assembly employers. It is time we the people start reminding the politicians that no matter how much the rich and corporate Virginians have paid to get them elected we can remove them from office if we have to, just consider the results of the 2017 commonwealth election. 
Northam threatens (nicely) to use amendment to muscle in Medicaid

By Laura Vozzella March 2 Email the author

RICHMOND — Gov. Ralph Northam on Friday gently warned state budget negotiators to send him a spending plan that includes Medicaid expansion or he will add expansion as an amendment, a procedure that gives him a stronger hand in the Senate.

If forced to go that route, Northam (D) said, he would have more power to shape an expansion deal already passed by House Republicans that calls for work requirements, co-pays and other conservative measures.

“We’ve obviously compromised, and if I send an amendment down — which I will if I need to — some of those compromises won’t be in there,” Northam later told reporters, noting that he would have more say over how to spend the $420 million in projected savings from expansion.

Northam won office last year on a promise to expand the federal-state health-care program to as many as 400,000 uninsured Virginians. Republicans in the House and Senate steadfastly blocked expansion for four years under Northam’s predecessor, Terry McAuliffe (D), saying the federal government could not afford to make good on its promise to pick up most of the $2 billion-a-year tab.

[Va. House speaker signals willingness to consider Medicaid expansion — with strings attached]

Opposition in the House softened this year after Republicans nearly lost control of the chamber in November elections. But there has been no visible shift in the state Senate. The GOP controls both chambers by two seats.

One longtime Republican moderate, Sen. Emmett W. Hanger Jr. (R-Augusta), supports expansion in some form, although he has objections to the plan passed by the House. Even if the plan could be modified to suit Hanger, the budget would still die on a 20-to-20 vote.

Lt. Gov. Justin Fairfax (D) presides over the Senate and can break most ties, but he is prohibited from voting on the budget. So Northam needs to win over two Republicans to pass a budget with expansion.

But Fairfax is allowed to vote on budget amendments. So if the legislature sends Northam a budget without expansion, Northam could add it as an amendment — one that could clear the Senate as long as a single Republican votes for it and Fairfax breaks the tie.

Northam made his intentions clear Friday morning over breakfast with a bipartisan group of state senators and delegates appointed as budget conferees. Their task is to reconcile the House and Senate budgets before the legislature adjourns March 10.

[Va. House speaker drops a few names — Trump and Pence — in Medicaid pitch]

Using a budget amendment to muscle through something as consequential as Medicaid expansion would be something of a hardball tactic for Northam, a soft-spoken former state senator and pediatrician with close friendships in both parties. But he did not overtly present the scenario as a threat. He shared it in response to a question posed by Senate Majority Leader Thomas K. Norment (R-James City), co-chairman of the Senate Finance Committee and a budget conferee.

“I answered his question that I did plan to send an amendment down,” Northam told reporters hours later at an afternoon gathering.

Asked how his response was received, Northam said: “I was asked a question, and I responded to it. . . . I didn’t have to do the Heimlich on anyone, so it was all good.”

Sen. Stephen D. Newman (R-Bedford), one of the budget negotiators, described the breakfast as “a very good, affable meeting.”

“I appreciate the governor’s candor,” Newman said. “He’s always an honest and honorable man to work with, and he has been straightforward on this, as he has been on other things.”

[Rural GOP legislator from southwest Va. comes out for Medicaid expansion]

But he took Northam’s statement as a concession that the legislature will send him a budget without expansion.

“I’m pleased to hear the governor stating publicly that he kind of anticipates the likelihood that the Senate will stay very strong throughout the entire budget process,” Newman said.

Newman also questioned whether the governor could count on Hanger’s support for such an amendment, given the senator’s concerns about the House-approved expansion plan.

“I don’t see a pathway today toward the McAuliffe-Northam plan,” Newman said. “I don’t know anyone . . . that anticipates that plan could actually make it in a reconvene session or in a regular session. I think Mr. Hanger and others who want to find a way in the Senate have said very clearly that that approach won’t work.”

Laura Vozzella covers Virginia politics for The Washington Post.

  Follow @LVozzella

Thousands flock to free medical clinic, as Washington dithers on health care

By Gregory S. Schneider July 21, 2017 Email the author

WISE, Va. — The sick and the disabled pour out of these mountains every summer for their one shot at free health care, but this year was supposed to hold hope for a better solution.

Donald Trump won the White House in part on a promise to fix the nation’s costly and inefficient health-care system. Instead, Republicans in Congress are paralyzed and threatening to dismantle the imperfect framework of Obamacare.

[Trump’s promise to “very quickly” repeal and replace Obamacare runs into reality]

No relief is in sight for someone like Larry McKnight, who sat in a horse stall at the Wise County Fairgrounds having his shoulder examined. He was among more than a thousand people attending the area’s 18th annual Remote Area Medical clinic, where physicians and dentists dispense free care to those who otherwise have none.

“I really think that they don’t have any clue what’s going on,” McKnight said of political leaders in Washington. “You watch the news and it’s two sides pitted against each other, which in turn just makes them pitted against us, the normal person.”

About 1,100 such people descended on the fairgrounds Friday, with more expected Saturday and Sunday. Medical personnel from across the state were there with makeshift examination rooms in tents and sheds. Sheets hung from clothespins for privacy; giant fans pulled hot air through buildings intended for livestock shows.

These events are staged nationwide, but the Wise clinic is among the biggest, drawing people from throughout Appalachia and casting Washington’s sterile political debates into the starkest human terms.

A third of the patients who registered Friday were unemployed. Those who couldn’t afford a room slept in their cars or camped in the fields around the fairgrounds. They lined up in the dead of night to get a spot inside the event.

Tabitha Lindley and her mother, Tammy Lindley, check for messages before dawn after sleeping in their car. In the foreground is Dalton Barton, Tabitha’s fiancee. They hoped to get dental work done. (Michael S. Williamson/The Washington Post)

Josh Phillips waited all night, with hundreds of others, for a chance at dental work. He rested in a wheelchair as he waited to be sent to a check-in area. (Michael S. Williamson/The Washington Post)

It is the place of last resort for people who can’t afford insurance even under Obamacare or who don’t qualify for Medicaid in a state where the legislature has resisted expansion.

At 37, with a long graying ponytail, McKnight had never been sick until about eight months ago. So he hadn’t worried too much about not being able to afford insurance on his roughly $18,000 a year in pay as an auto mechanic. But now he was getting a referral to the University of Virginia hospital to check for the source of his pain, which he had vowed to withstand without resorting to opioid medication.

“The normal person doesn’t care about a lot of the things that they care about [in Washington]. Most people want to work, they want insurance and they want to be able to take care of their family without assistance,” he said.

The only way to do that, he said, is to have everybody — the healthy and the sick — paying into a centralized health insurance plan. “I really think the only thing that would truly help this country is if it were single-payer,” McKnight said.

Around here, that’s not politics, it’s just life. Many of these people voted for Trump — not only for his vow to fix health care, but also for his promise to bring back the coal industry. They’re still waiting for results, with varying degrees of patience.

[Trump’s promise to bring back coal jobs won’t be met, experts say]

Patricia McConnell was having trouble speaking around the bloody gauze in her mouth. She had just had four teeth pulled. The unemployed former manager of a McDonald’s had driven eight hours from her home in Glen Burnie, Md., to attend the clinic.

Virginia Gov. Terry McAuliffe hugs Patricia McConnell, who saved money for six months for gas and a hotel room to attend the Remote Area Medical event and have dental work done. (Michael S. Williamson/The Washington Post)

“My teeth were hurting,” she said. McConnell, 63 and disabled, said she had health insurance through Medicaid but no dental coverage.

So this was her dental plan: She’d save for six months to afford a motel room and gas, then wait in line in the morning heat to see a volunteer dentist.

McConnell has been watching the health-care debate in Washington and wondering if it will ever amount to anything that actually helps people like her. “I don’t know what they’re trying to do,” she said, struggling to get the words out around the gauze.

She voted for Trump, she said, and still feels that he’s working hard to help. But his anger and his tweets seem to aggravate Congress, and no one is working together, she said.

They need to set all that aside and work to pass health care for everyone, she said. “Let’s get this done.”

Others had a hard time mustering the faith that anyone cared.

“They’re trying to kill us poor people, is what they’re trying to do,” said Robert Horne, 55, a disabled former construction worker seeking dental care. Horne said he voted for Hillary Clinton last fall because of her pledge to maintain the Affordable Care Act.

That didn’t work out, either.

Virginia Gov. Terry McAuliffe (D), who flew out to the clinic Friday morning, had invited Senate Majority Leader Mitch McConnell to join him but said that the Republican leader “politely” declined. McAuliffe, who visits the clinic every year, spent nearly two hours touring it — twice as long as scheduled — and took every opportunity to proclaim that he’s been trying for three years to get the state legislature to agree to expand Medicaid under Obamacare.

The Republican-controlled General Assembly has resisted, unlike the legislatures in nearby states, which McAuliffe kept reminding the patients and doctors who crowded around him on the hot fairgrounds.

Virginia Gov. Terry McAuliffe chats with Joey Johnson of Clintwood, Va., who is confined to a wheelchair. (Michael S. Williamson/The Washington Post)

Kaitlen Hagy, 3, tries to keep cool with a hand fan at the Wise County Fairgrounds. She was in line for eyeglasses. (Michael S. Williamson/The Washington Post)

“All of our neighbors in Kentucky and West Virginia and Maryland — they did it!” he said to a Christian counseling group that had set up shop under an awning. But in Virginia, he said, legislators turned down millions in federal dollars that would be available under Medicaid expansion.

[“If Obamacare is here to stay, it’s time to expand Medicaid,” McAuliffe says]

“We need it,” called out Tonya Hall, operations director for a hospice-care facility. “Let them come and visit some in southwest Virginia. Let them see the poverty. Let them see how we live. Let them come.”

“This isn’t about politics,” McAuliffe said.

“Right!” Hall agreed. “It’s about people.”

“It’s about people’s lives,” McAuliffe said to a round of “Amens” from the group.

Hall, 42, said she had voted for Trump but that she was disappointed he hadn’t been able to do anything to improve the health-care system. If Obamacare can’t be fixed, she said, “then I say we scrap it and start over. You can see the need,” she added, gesturing at the masses of people waiting for their turn with a medical professional.

Beyond her, a long line stretched into the triage tent, where people were sorted and their vital signs measured. Allen Sexton, 37, was there to have all his teeth removed, years after a car accident had left them a scrambled mess.

In a metal shed nearby, vision specialists sat in darkness, performing eye exams in pools of light. One man said that his glasses had broken a year ago and that he couldn’t see at a distance or up close, but he’d been driving anyway.

There was another tent for orthopedic care. Another for basic checkups. Each one was full, with more people waiting outside on metal folding chairs or standing in lines.

Politicians prowled the fairgrounds. Several area legislators attended while Attorney General Mark Herring (D), running for reelection, walked with McAuliffe and Sen. Tim Kaine (D) helped register patients.

Stan Brock, the English philanthropist who founded the RAM clinic program more than 30 years ago, said there was one more visitor he’d like to see at the clinic.

“It’s absolutely imperative that the president of the United States come and visit one of these events,” he said. “I believe if he did, he would take some immediate action.”

Greg Schneider covers Virginia from the Richmond bureau. He was The Washington Post's business editor for more than seven years, and before that served stints as deputy business editor, national security editor and technology editor. He has also been a reporter for The Post covering aviation security, the auto industry and the defense industry.

  Follow @SchneiderG

The Virginia GOP’s Medicaid plan: Just say no & Va. Republican offers plan to end Medicaid deadlock 29MAI14

VIRGINIA's repiglican / tea-bagger controlled House of Delegates needs to be called out for their hypocrisy on their claims to be Christian inspired defenders of the sanctity of life. They propose, and at times pass, legislation restricting a woman's access to abortion and even some forms of birth control, and then vote to deny health care expansion of Medicaid to the least among us, those Christ himself teaches us to care for (with no caveats about system abusers). So much for the sanctity of life once a child is born. So much for their claims to be guided by their faith. On the expansion of Medicaid they are hypocrites, and the proponents of expanding Medicaid to the 400,000+ Virginians who need it should start a Sanctity Of Life Roll Call of Shame with every Virginia legislator opposing Medicaid expansion listed on it. Virginia's repiglican and tea-bagger Richmond legislators don't hesitate to attack the morality of pro-choice and women's right legislators so turn-about is fair play. Who among the supporters of Medicaid expansion in Virginia has the courage to publicly expose the immorality of the opposition?
The "compromise" legislation proposed by VA sen emmett w hanger jr r Augusta and delegates william j howell r tb Stafford and m kirkland cox r tb Colonial Heights is nothing more than the deceptive obstructionism of the national gop / tea-baggers at the state level. They will use this proposal in their propaganda campaign against Gov McAuliffe's administration, seeking to build political pressure on the Democrats and the Governor to accept this immoral compromise to avoid a government shutdown, and will use it against him if the Democrats and the Governor when they reject it. NOW is the time for Gov McAuliffe to show the people of Virginia he isn't a DINO, and that he not going to be played by his political opposition in Richmond. These from the +Washington Post .....

The Virginia GOP’s Medicaid plan: Just say no

By Editorial Board, Published: May 29

WITH VIRGINIA lacking an enacted budget and facing the growing risk of a government shutdown in just over a month, the top Republicans in the House of Delegates, Speaker William J. Howell (Stafford) and Majority Leader M. Kirkland Cox (Colonial Heights), requested an urgent meeting the other day with Gov. Terry McAuliffe (D). Eager to surmount the impasse that may imperil Richmond’s ability to provide public safety, health care and other basic services — to say nothing of the state’s bond rating and reputation for good governance — surely the GOP bigwigs had constructive ideas, possibly even one that might sow the seeds of compromise.
They didn’t. In a 30-minute meeting, Mr. Howell and Mr. Cox had the same old one-note message about Medicaid expansion, which 27 states have now embraced. Their message was: No. They might as well have issued a news release and called it a day.

The two men didn’t just repeat their negative message; they broadened it. In the past, they have said no to expanding Medicaid under the Affordable Care Act. Then they said no to a Senate-approved proposal — one drafted by a Republican and designed to appeal to conservatives — that would use new federal Medicaid funds to buy private insurance for low-income enrollees.
Finally, in the meeting with Mr. McAuliffe on Tuesday, Mr. Howell and Mr. Cox said no to a plan similar to that proposed by one of the most conservative Republican governors, Mike Pence of Indiana. Mr. Pence, like GOP governors in Arizona, Arkansas, Michigan, Pennsylvania, Utah and elsewhere, is seeking a deal that would unlock hundreds of millions of dollars in Medicaid funds for an alternative to Medicaid. His plan would expand an existing state program that relies on health savings accounts to which participants contribute 2 to 5 percent of their monthly income; the state chips in Medicaid funds up to a strict limit.
Mr. Howell and Mr. Cox have no plan to cover the hundreds of thousands of low-income residents of Virginia who lack health insurance. Their only apparent agenda is to deal a political defeat to Mr. McAuliffe, who ran last year on a promise of expanding Medicaid, and by extension to President Obama. If the question contains the word “Medicaid,” Mr. Howell’s and Mr. Cox’s answers contain the word “no.”
Their strategy, if you can call it that, is likely to lead to disaster. Without a budget, salaries for the state’s 100,000 employees, who include police, prison guards and hospital workers, cannot be paid as scheduled on July 1. Ditto payments to holders of Virginia’s bonds, including those due $66 million on July 16 and $235 million on Aug. 1. Wall Street rating agencies will take immediate notice and are likely to downgrade the state’s bond ratings, which will cost Virginians millions more in higher interest payments.
Taking the governor for a fool, the GOP House leaders say they want to sever Medicaid from the budget and consider it separately in a special session. But since they have been crystal clear that their intent is to kill any Medicaid expansion plan, their proposal is really no proposal at all — again.

Read more:
The Post's View: Virginia plays chicken with Medicaid
The Post's View:Va. Republicans’ lonely Medicaid stand

Va. Republican offers plan to end Medicaid deadlock

By Laura Vozzella, Updated: Thursday, May 29, 9:52 PM E-mail the writer

RICHMOND — A key Republican ally in Gov. Terry McAuliffe’s bid to expand health coverage for the poor offered a plan Thursday to a break a months-long deadlock on the issue. But he also split with the governor by questioning McAuliffe’s power to keep government running without a budget or to expand Medicaid on his own.
Sen. Emmett W. Hanger Jr. (R-Augusta) offered a proposal to end the General Assembly’s budget-Medicaid stalemate, which threatens to shut down state government if it is not resolved by July 1, the start of the new fiscal year.

Proposal separates the issue from the budget debate but tilts state panel toward health-coverage expansion.

Hanger’s plan asks both sides to give a little, divorcing the Medicaid issue from the budget as opponents want but also remaking a state Medicaid commission so it could no longer block expansion. But the nitty-gritty made the plan somewhat more appealing to the GOP-dominated House, which opposes expansion, than to the evenly divided Senate, which narrowly supports it with the backing of Hanger and two other Republicans.
That the plan also came with a strongly worded statement questioning McAuliffe’s expansive view of his powers stoked hopes in the GOP that Hanger might be wavering. But Hanger said that was not the case.
“I’m not, by any means, backing away from my commitment,” Hanger said.
He said he was surely onto a good compromise because he’d gotten “a little pushback” from House Republicans as well as “my buddy Dick Saslaw,” referring to Senate Majority Leader Richard L. Saslaw (D-Fairfax), a leading advocate for expansion.
House Speaker William J. Howell (R-Stafford) and other House GOP leaders cheered the parts of the plan that appealed to them — splitting Medicaid from the budget, taking a limited view of the governor’s powers — but were silent on the rest. Thursday afternoon, McAuliffe said he was “intrigued” by the plan and eager to learn more, but Saslaw was dismissive of it later in the day.
“That’s just one guy’s idea, and it ain’t a majority opinion,” Saslaw said. “The House may love it, but there’s not a lot of traction for it at this point.”
McAuliffe and the Senate support using Medicaid money to provide private insurance to 400,000 low-income, uninsured Virginians. They say that will help needy residents and boost Virginia’s economy at little cost to the state. Under the federal Affordable Care Act, Washington initially promises to pay 100 percent of the cost, with that share gradually reduced to 90 percent.
Republicans contend that Medicaid needs to be changed more extensively before it is expanded. They also fear that Virginia could get stuck with the $2 billion-a-year cost of expansion if an overextended Washington can’t keep its funding promise.
The dispute has prevented passage of a two-year, $96 billion state budget because the Senate includes it in its spending plan but the House does not.
Hanger’s proposal would pull Medicaid out of the budget, robbing the pro-expansion camp of its chief leverage. But it also calls for changing voting requirements for a state Medicaid commission to tilt control toward expansion supporters and away from opponents, who have the upper hand now.
There is a catch for those in favor of expansion: Hanger’s plan calls for the House only to consider the Medicaid commission bill, not pass it. Hanger said the Senate would maintain some leverage since negotiators would work on the budget and the Medicaid commission bill at the same time.
“If you’re working it concurrently, you have to have an element of faith, and you also still hold the cards,” he said. “Even though they’re decoupled, if the other side is not working with you in good faith, you really don’t have to pass the budget, either.”
Hanger issued the plan along with a strongly worded statement countering McAuliffe’s contention that he could keep the state government operating without a budget. Hanger also rejected the idea that McAuliffe could expand Medicaid through executive action — a route the administration has privately explored.
It “would be totally unacceptable for the Administration to assume executive powers to operate Virginia’s government without an approved budget or to expand Medicaid without the concurrence of the legislature,” Hanger wrote.