Uncertainty and a wide partisan divide over health care vote in Virginia

Travis Fain
Contact Reportertfain@dailypress.com

Thursday's House vote to repeal Obamacare, a rush job after amendments broke a logjam Wednesday on the long-lingering Trump campaign promise, left Virginia politicians at odds over just what the bill would mean back home.

Most of that division was along party lines, but even Republicans praising a step toward the potential death of the Affordable Care Act were were trying to absorb nuances of the legislation after the vote and hoping for changes as it heads to the U.S. Senate.

U.S. Rep. Rob Wittman, R-Westmoreland, said the bill ticked off enough boxes for him to support it, and he believes it "puts in place policies that will expand health care choices, increase access to care, and reduce costs."

Wittman also said the bill "does what is necessary to protect individuals with pre-existing conditions."

All of that is in contention, and Democrats blasted the vote Thursday as one Republicans would rue come the 2018 congressional elections. This amended version of the American Health Care Act didn't draw any "yes" votes from Democrats, and 20 Republicans voted no. Among Virginia Republicans, only U.S. Rep. Barbara Comstock, who represents a swing district in Northern Virginia, voted no.

U.S. Rep. Robert C. "Bobby" Scott, D-Newport News, spoke against the bill on the House floor Thursday, rising to inform his Republican colleagues how many of their constituents would lose health insurance under the measure.

U.S. Rep. Scott Taylor, R-Virginia Beach, accused Democrats of lying about the bill's effect and said the bill represents a path away from the "biggest taxing scheme in the history of our nation." He called the bill "far from a final piece of legislation," but also "the vessel that will rid us of D.C.-mandated health care."

The vote immediately reverberated in Virginia's governor's race.

U.S. Rep. Tom Perriello — who was in Congress just long enough to help vote Obamacare into existence — dropped a new ad shortly after the vote. It's 30 seconds of him blasting Republican health policy and promising better in Virginia as an ambulance is smashed behind him in a car compactor.

Lt. Gov. Ralph Northam, Perriello's competition in the June 13 Democratic primary, released a statement calling the House vote "the most spineless, unprincipled cruelty that I have ever seen come from a legislative body."

Two Republican candidates for governor, Ed Gillespie and state Sen. Frank Wagner, called the vote an important first step. Wagner, R-Virginia Beach, said he wants to see as much flexibility for the states on health policy as possible.

Gillespie, like other Virginia Republicans, noted this week's news that Aetna plans to leave Virginia's individual insurance market, including the exchange set up by Obamacare. He promised to monitor the bill as it morphs and to look for ways to adapt state policy to the final product.

"We must ensure that every Virginian has access to quality, affordable health care," Gillespie said in his statement.

Prince William County Board of Supervisors Chairman Corey Stewart, the third Republican in the governor's race, said he wants to see Medicaid turned into a block grant program, in which the federal government sends set amounts of money down to the states. State budget writers have eyed this possibility warily.

The Medicaid cuts in this bill, and the per-capita cap it would place on federal reimbursements for enrollee care, have a number of states concerned that the bill will push costs down to them. This could be exacerbated in Virginia, where Republican lawmakers declined to expand Medicaid and the much higher per-enrollee payments it promises from the federal government.

The cap is meant to control federal spending, College of William and Mary professor Jennifer Mellor said via email, and could force states to cut benefits or cap enrollment.

"Some of the groups with the highest Medicaid costs are older, sicker, seniors on Medicaid," said Mellor, who heads the Schroeder Center for Health Policy. "There is a lot of uncertainty about how states will address this."

Virginia Speaker of the House William Howell, R-Stafford, said in his statement that legislative leaders would monitor the bill as it changes.

"Ultimately I would like to see Congress pass a bill that gives flexibility to the states to lower premiums and provide better quality coverage," Howell said. "Most importantly, we need to make sure this legislation does not punish Virginia for being a fiscally-responsible state and for not expanding Medicaid."

Virginia's two U.S. senators, Tim Kaine and Mark Warner, both Democrats, blasted the bill and the quick voting timeline Thursday.

Kaine echoed complaints from Democratic leadership in the House, saying the bill was more about tax cuts for the rich than health policy. He called on the Senate to await a scoring from the Congressional Budget Office, which had not completed its review of the bill's costs and effects ahead of Thursday's vote in the House of Representatives.

Warner said House Republicans "voted to take away health care coverage from millions of Americans."

"This was a bad bill a month ago, and it's a worse bill now," Warner said in a statement. "I will fight tooth and nail to keep it from passing the Senate."

Both senators said the legislation would hurt people with pre-existing conditions, a key point Republicans were unwilling to concede. Taylor, who's in his first term, said the same people who pitched Obamacare with promises that everyone with a plan they liked could keep it were now "attempting to scare our neighbors, saying pre-existing conditions are not covered.

"This is a lie," Taylor said in his release.

Current law requires insurers to offer coverage to everyone and says they can't charge people more if they have a pre-existing condition.

"As passed, the AHCA allows states to get a waiver so that insurers could charge people with pre-existing conditions more," Mellor said in an email.

Funding was added to the bill to help cover these costs, but there are widespread concerns the money will be too little to truly help.

Fain can be reached by phone at 757-525-1759.

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