Dear Friends,
First of all, Happy Easter to you and your family! No matter how many difficulties we may experience in life or in the political arena, we can always rejoice in the knowledge that Our Lord has triumphed over death. That is true victory and true hope!
Returning to the mundane:
PLEASE TAKE A MINUTE TO URGE YOUR DELEGATE AND SENATOR TO VOTE NO ON HB 2313 AND MEDICAID AMENDMENTS TO THE BUDGET-HB 1500.
The General Assembly “Veto Session” is this Wednesday, April 3. As you may recall, the AG responded to my inquiry that the original Transportation Bill regional taxes (in HB 2313) and the Budget Bill language on Medicaid Expansion (in HB 1500) were unconstitutional.
TRANSPORTATION BILL:
Instead of offering separate amendments, Governor McDonnell has offered a “substitute” HB 2313 bill to address the constitutional problems with HB 2313 since the AG ruled that “special” taxes which apply to certain regions are not constitutional. The Governor’s new bill mandates that all regions (not just Northern Virginia and Hampton Roads) will be subject to the extra taxes once the planning districts of which they are a part meet certain criteria: population of 1.5 million, not less than 1.2 million motor vehicles registered, and transit ridership of not less than 15 million per year. The revenues will be deposited into separate “Funds” for the Northern Virginia Transportation Authority and the Hampton Roads Transportation Authority.
This ensures future automatic tax increases for the other Planning Districts without a separate vote of the General Assembly. I think such a policy, while perhaps legal, is not prudent. Who can predict the needs of localities in ten or possibly 100 years? Can Planning District boundary lines be reconfigured to collect taxes sooner? Does this conflict with our constitutional requirement that laws must take effect on July 1 of the year in which the bill becomes law, yet these taxes might not start for some areas for twenty or more years?
The NVTA and HRTA are to act as independent bodies of the state government and VDOT:
15.2-4839 2. The Authority is independent of any state or local entity, including the Virginia Department of Transportation (VDOT) and the Commonwealth Transportation Board (CTB), but the Authority, VDOT and CTB shall consult with one another to avoid duplication of efforts and, at the option of the Authority, may combine efforts to complete specific projects.
The NVTA and HRTA will receive millions of our tax dollars, decide how they will be spent and can even invest in security instruments. The Metropolitan Washington Airports Authority (MWAA) has been criticized by the federal Government Accountability Office (GAO) for cost-overruns and no-bid contracts. Increasing the number of Authorities over which citizens have little ability to influence policy is a dangerous delegation of power in my opinion.
MEDICAID EXPANSION:
The AG replied to my inquiry, affirming his earlier opinion to Delegate Ben Cline, that the General Assembly cannot delegate its power to expand Medicaid to a Commission which includes a few members of the General Assembly. Governor McDonnell nevertheless declined to change the language affecting the delegation to a subgroup of the Assembly, so the same legal-constitutional problems the Attorney General pointed out are still present in the amended version.
The Governor has offered four new amendments to HB 1500 on Medicaid. Please urge your delegate and senator to reject them:
Amendment 22: Adds up to five additional employees from other agency personnel for the Department of Medical Assistance Services (DMAS) to fully comply with new provisions of health care reform.
Amendment 23: Provides $870,000 from the general fund to cover the rest of a $1.67 Million contract to George Mason U which will mostly contract with the Center for Health Innovation. (Future budgets will surely add more funding.)
Amendment 24: Strikes certain lines on pages 295-297 of the Budget intended to add specificity to Medicaid reforms, (not definitive in my opinion).
Amendment 25: Creates a $3 Million Medicaid customer call center by allowing DMAS to contract with a vendor so individuals can apply for Medicaid by telephone, as required by the federal government by October 1, 2013. $1.5 million comes from Virginia. Costs could increase depending upon the final contract and center workload. More funding could be provided next year.
The Heritage Foundation estimates Medicaid expansion will cost Virginia an additional $902 Million through 2022, requiring massive tax increases or cutting (unlikely) other Virginia programs.
Harvard’s Malcolm Sparrow in 2009 testified before Congress that Medicaid bills continue to be paid to physicians after they die, to treat patients after death, to treat immigrants who have been deported. He noted that the Credit Card Industry has a threshold of one-tenth of one percent for acceptable business fraud risk. Medicaid losses from fraud range from 3-14%, not including billing errors!
It is folly to think that ten part-time members of the General Assembly meeting once a month for a few months can ensure Virginia will be able to exercise adequate oversight over expanding 400,000 new recipients to the current 1,000,000.
And, while some Assembly members believe Virginia can expand Medicaid, accept the three year 100% federal subsidy, and then opt out later, The U.S. Supreme Court did not rule states could leave Medicaid once enrolled nor is there an opt-out provision in the Affordable Care Act.
Republicans used to complain when Democrats proposed tax increases and expanded government programs. Now Republicans are putting them to shame, leading the charge to saddle present and future taxpayers with greater financial burdens.
PLEASE TAKE A MINUTE TO URGE YOUR DELEGATE AND SENATOR TO VOTE AGAINST HB 2313 AND MEDICAID AMENDMENTS TO HB 1500.
Thank you,
Delegate Bob Marshall
