Virginia's McAuliffe Exploring Executive Order on Medicaid Expansion

Image: Virginia's McAuliffe Exploring Executive Order on Medicaid Expansion

Friday, 02 May 2014 09:29 AM

By Sandy Fitzgerald

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Virginia's new Democratic governor and his advisers are investigating expanding Medicaid without the approval of the state's GOP-dominated House of Delegates, The Washington Post reported.

Gov. Terry McAuliffe, who took office in January, and his advisers are contacting attorneys, lawmakers and healthcare experts about how to bypass the Republican House, sources told the Post. One of the sources, speaking like the others on the condition of anonymity, said state Attorney General Mark R. Herring, a Democrat, has been researching the matter.

The governor argues that expansion would boost the state's economy by $5 million a day. Republicans argue that the federal government can't keep its promise to pay the $2 billion a year the program will cost in its initial three years.

State Senate Majority Leader Richard L. Saslaw, D-Fairfax, told the Post that he is not  aware of plans by the McAuliffe administration to enact an executive order if a legislative deal can't be reached, but he did not rule out the possibility.

"The best way to do it, I think, would be through the [legislative] process, but that may or may not be the only way to do it," he said.

Only two other governors — Ohio Republican John Kasich and Kentucky Democrat Steve Beshear — have been able to push Medicaid expansion past opponents. However, several states have approved Medicaid expansions, including nearly a dozen states with Republican governors.

But the issue could cause legal questions for McAuliffe and create a political struggle between him and the Republican legislature.

Opponents such as Republican Delegate S. Chris Jones, who chairs the House Appropriations Committee, say they don't believe the governor has the authority to push through a Medicaid expansion. Both McAuliffe and Herring this past week sidestepped questions about whether the governor plans to enact the expansion by executive order.

Both Kasich and Beshear took advantage of loopholes in their states to enact the Medicaid expansions, according to the Post. Kasich used his state's Controlling Board to approve the expansion, while Beshear authorized the expansion because Medicaid rules are set up in state regulations that can be changed by executive order.

But Virginia's state constitution requires its legislature to approve all appropriations, including Washington funding, according to the Post. States that approve Medicaid expansions get the bill footed by the federal government for the first three years.

Republican Virginia state Sen. Sen. Emmett W. Hanger Jr., who supports expansion, said legislators and the administration have discussed the expansion several times, but says nobody has told him that the administration is definitely talking about using an executive order.

"They're intrigued by what Governor Kasich did in Ohio," Hanger said, according to the Post. "There have been numerous instances where the speculation turned to whether or not it could be done administratively, but there’s never been anyone that has clearly said, 'Yes and we’re working on a plan.'"

Hanger also said an administrative move could cause too many political problems while not standing up to a legal battle.

McAuliffe has said the expansion is his top priority and said he could sell House Republicans on the move. But the House isn't budging, and a budget stalemate threatens to shut down the budget if a resolution isn't reached by July 1.

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