Do not withhold good from those to whom it is due, when it is in your power to act.
— Proverbs 3:27
Some may say that Virginia’s Medicaid program — based on a 50/50 cost share with the federal government — is financially unsustainable, that costs keep rising, and enrollment continues to grow. For several years, based on this argument, the General Assembly opposed access to health care for 400,000 people in the coverage gap created by the United States Supreme Court when justices made optional any state eligibility expansion up to 138 percent of Federal Poverty Level.
I confess to my own votes, repeatedly, year-after-year, against straight Obamacare expansion, but this year I asked myself whether such rationale for continuing my opposition still holds up to moral and logical scrutiny. Is my continued opposition indicative of a broken welfare program not worth further investment or, instead, reflective of an economy in which lower and middle-class families continue to struggle in the midst of a so-called recovery?
To answer this question, experience, reason, and faith have been and continue to be my guide. In my legal practice, I find myself visiting many homes of low-income, sick, mentally ill, or substance-addicted Virginia families who are either on Medicaid, or are the “working poor” — hardworking families making too much money to be eligible, but not enough to sustain the quality of life to which we all aspire. These experiences are profoundly humbling, and I commend them to my colleagues.
What is real in our community is a significant struggle telling of greater structural issues than those found in any government-sponsored health-care program for the very poor, children, or the disabled. Truth be told, society has lost its mitigating influences where, in the past, people who are down and out would solicit help from their families, neighbors, or faith communities.
Much of this decline is attributable to the government occupying the space previously occupied by churches and other communities of compassion. Many Virginians who are mothers and fathers, sisters and brothers in our communities find their ability to meet basic human needs as Barbara Johns described: “Reaching for the moon.” Far too often achieving the basic needs of life with dignity are just out of reach. I can assure everyone that there is no one rushing to get their Medicaid because they are affluent, have enough to meet their own needs, or because it is such an awesome public benefit. It is used because it is needed.
Most issues we deal with are not black and white, and I have been really wrestling with the expansion question for some time, even as I have been part of a united front to oppose Obamacare’s Medicaid expansion. Could I or anyone reading this commentary imagine being in a family of three where you would be ineligible for Medicaid if you made more than $6,700 a year? My guess is that if you are reading this section of the Richmond paper that your answer is no.
Nevertheless, for the same reason, you may also be persuaded by arguments about ensuring Virginia’s sound fiscal management. Regardless of where you fall, here is my rationale for supporting a program that hopes to give a hand up rather than a hand out:
The House is seeking to help low-income Virginians who are working hard but need help with health-insurance coverage. Obamacare has devastated the working class, making employer-sponsored insurance difficult to afford even for those doing well. Our goal is to offer people an opportunity to find the dignity of work and a path forward in a manner similar to the plan endorsed by Mike Pence in Indiana.
With Donald Trump in the White House, now is our time to ensure essential reforms are included in any Medicaid plan. If the House doesn’t act now in this way, then a straight-forward Medicaid expansion is likely.
Our plan aims to put low-income Virginians in private insurance plans with premiums and co-pays, giving them skin in the game. The plan sets up health savings accounts so people are incentivized to make their own health-care decisions, and we are implementing a “Training, Education, and Employment Opportunity” program. We also have installed a “kill switch” where, should the federal government ever back out of the deal, the enhancement of Medicaid ends.
These reforms are contained in the budget passed by the House of Delegates this session in a new two-year spending plan for the commonwealth that invests in critical core services for fiscal years 2019 and 2020. House Republicans believe that our balanced budget approach is the most prudent and thoughtful plan to grow our economy and improve the lives of all Virginians. In order to carefully guard the taxpayer dollar, our budget also balances without raising general fund taxes. With a major deposit to a new cash reserve fund, we are able to protect our coveted, money-saving Triple-A bond rating.
Core functions — like K-12 education, higher education, transportation, and public safety — remain the most important areas of state government. We have consistently focused on these core priorities, rather than creating new or unnecessary programs. For example, in elementary and secondary education, the House budget fully funds the standards of quality and additionally provides a 2 percent teacher pay raise — six months sooner than former Gov. Terry McAuliffe proposed. Maybe most important, the House budget directs more money back to local schools with no strings attached, through lottery dollars.
The House budget also invests in our sheriff’s deputies who have primary law enforcement responsibility, with a $1,000 per deputy raise. In counties like Hanover, King William, and New Kent, our citizens are blessed every day by the risks that these men and women take on the road or in the courtroom. Should you support this reasonable and pragmatic approach to governing, register your support: virginiahouse.gop/reform.
Being able to impact these important decisions that affect so many lives is humbling. My family has always taught me that to whom much is given, much is expected. In much the same way I also try to impart to my children the importance of selfless service to others. More classically, the principle is best summed up as, “Not for ourselves alone are we born” (Cicero). And thus, in 2018, the moment has arrived to make an even greater impact for those often marginalized, cast down or aside, and provide them hope.
Christopher Peace, a Republican, represents the 97th District in the Virginia House of Delegates. Contact him at DelCPeace@house.Virginia.gov.