Bill Bolling

Lt. Gov. Bill Bolling said today that Virginia should not expand its Medicaid program that provides health coverage for the poor, asserting that such a move “would place tremendous fiscal pressure on the Commonwealth and divert funds from other state programs.”

Bolling, a candidate for governor in 2013, made his case in a letter to Gov. Bob McDonnell.

“Medicaid is already one of the fastest growing areas of the state budget, accounting for almost 20 percent of total state general fund expenditures,” Bolling wrote.  “The cost of administering the Medicaid program has increased by more than 80 percent from 2002 to 2011.  This is simply an unsustainable rate of growth that will only get worse if we add 425,000 more people to the program.”

McDonnell said earlier this week that he is considering opting Virginia out of  expanding eligibility for the Medicaid in the aftermath of the U.S. Supreme Court ruling preserving the federal health care overhaul. In its decision, the court ruled that the federal government could not withhold existing federal Medicaid funds from states that opt out of  expanding their programs to include individuals and families with incomes up to 133 percent of the poverty level.

The federal government would cover the full cost of the expansion for three years beginning in 2014,  and then gradually reduce its share to 90 percent by 2020. But McDonnell has said the expansion still would cost the state as much as $2.2 billion over 10 years, an estimate his administration is reassessing. He told state lawmakers earlier this week that he wants more information from the Obama administration about rules for Medicaid expansion and health benefits exchanges. But he also hopes the health care law is repealed after this fall’s elections.

Attorney General Ken Cuccinelli, who also will run for governor next year, said on the day of the court’s ruling that Virginia should examine opting out of the expansion.

Virginia’s Medicaid eligibility standards are among the strictest in the country, but McDonnell routinely complains about the program’s rising costs, which are split between the state and federal governments.

On Wednesday, U.S. Rep. Gerry Connolly, D-Fairfax County, urged McDonnell to move forward with the expansion. In a letter to the governor, Connolly said the state would lose $9.2 billion in federal funds over the first five years by opting out of the program. Refusing to participate would leave as many as a quarter-million Virginians, who would then turn to more expensive hospital emergency rooms for care.

“It is time to put policy decisions ahead of political posturing for the good of the Commonwealth and its citizens,” Connolly wrote.

The advocacy group Virginia Organizing, which focuses on issues affecting poor and low-income citizens, charged that McDonnell’s “wait and see” approach is motivated by politics.

“The Governor seems to think that gambling with the health and lives of real people is an appropriate response to the U.S. Supreme Court decision,” said Virginia Organizing Chairwoman Sandra Cook in a news release. “This is nothing more than Governor McDonnell playing partisan politics while disregarding the well-being of those who obviously need this expansion in order to have health coverage.”

– Michael Sluss