Virginia has been a leader in Medicaid reform, but it will fall behind if it resists a proposed expansion of the insurance program.
In pursuing a transportation deal this winter, Gov. Bob McDonnell dispensed partisan sound bites but planted his feet in the commonwealth’s center, where most of his constituents reside. The result is a pragmatic road and rail package that may not please everyone in his party, but it rewards him with the legacy he sought.
McDonnell now faces a decision with consequences that could overshadow that achievement. A federal plan to expand the Medicaid insurance program to cover low-income workers remains alive in Virginia but its future is murky. The commonwealth is all but certain to delay implementation for six months after other participating states have gotten started next January. There is a danger that Virginia could fall much further behind in providing medical care for the uninsured and pursuing reforms to ensure Medicaid is financially sustainable.