Health plan compromise will work for Virginia

Published 10:22 am Wednesday, March 7, 2018

[Editor’s note: This column originally appeared in The Virginian-Pilot and is reprinted here with permission.]

by Frederick M. Quayle

One thing that has long bound Republicans and Democrats in the General Assembly is a bipartisan belief in the Virginia Way — the notion that in Richmond we can, and should, do things differently than Washington and that our party differences do not consign us to paralyzing gridlock at the expense of the millions of Virginia voters who send representatives to Thomas Jefferson’s Capitol to conduct the people’s business.

Cynicism certainly can be tempting in polarizing times when we see elected officials in both parties pulled in one extreme direction or another. But from my home here in South Hampton Roads, it is heartening to witness a modern example of cross-aisle cooperation on health care policy in the House of Delegates.

Led by Republican leaders such as Speaker Kirk Cox and my delegate, Chris Jones of Suffolk, the chairman of the budget-writing Appropriations Committee, the House has produced a health care coverage plan that both sides can agree on.

The House plan accomplishes the goal of getting more low-income people insured — to benefit public health and our economy — in a measured way that protects Virginia financially and requires new beneficiaries to invest in their own health and personal betterment.

The House compromise requires both sides to be flexible. It isn’t a slam dunk for either side. It is a typical example of governing from the middle, which is what most Virginians want from their elected officials.

Conservatives who continue to voice legitimate concerns about the structure of the Affordable Care Act and its role in our health care system can take satisfaction in the House plan’s inclusion of work, training and education requirements for able-bodied new enrollees, its incorporation of private-sector managed-care plans and its medical co-pay standards. There’s also a financial escape hatch to protect Virginia if Washington ever fails to meet its funding commitment.

Democrats who favor straightforward Medicaid expansion don’t get everything they want out of this plan, either. If they had their druthers, it’s probably safe to assume they would not have written a budget with some of the conditions in the House plan.

But that is the essence of compromise. No one gets everything they want. President Ronald Reagan once famously said of compromise: “If I can get 70 or 80 percent of what it is I’m trying to get … I’ll take that and then continue to try to get the rest in the future.”

If we had written a health care reform bill from scratch, the finished product likely would be much different than the Affordable Care Act. We don’t have that luxury. We have to work with the hand that’s been dealt. Congress has failed to repeal and replace ACA. The U.S. Supreme Court has upheld the law. As Jones explained, we must accept that the law is here to stay.

We also have to accept the fact that in America, people receive health care even if they can’t pay for it. People in need aren’t turned away by hospitals. They get medical attention. And the cost of that gets passed on to the public and private sector through higher insurance rates and health care costs. Ignoring that won’t fix the situation. It will make things worse.

It’s unlikely Washington will fix things, either. After all, Congress created Medicaid and Medicare in the 1960s, and Reagan signed a law in the 1980s that requires hospitals to care for all patients seeking emergency care. These programs are here to stay, so we must address their challenges.

As someone who spent 20 years in the Senate of Virginia, I am encouraged to see how the House plan has attracted support in urban and rural communities across the commonwealth, and from Republicans and Democrats. We should commend Cox, Jones, and Del. Terry Kilgore from Southwest Virginia, to name a few, for advancing this important conversation. I share the sentiments of my friend and former Senate colleague, John Watkins of Powhatan County, in encouraging the General Assembly to find compromise that exemplifies the Virginia Way without taking counterproductive steps, such as taxing hospitals, that could have unintended consequences.

Working with Gov. Ralph Northam, a Democrat from the Eastern Shore, I hope that citizen leaders representing Hampton Roads will be at the forefront of collaborative efforts to find compromise on health care that helps people in need. I feel fortunate to be able to get skilled medical care in my community. In a fiscally responsible way, the House plan puts that care in reach for thousands of our fellow Virginians.

FREDERICK M. QUAYLE is a Republican who served 20 years in the Virginia Senate representing a district that included parts of Chesapeake, Franklin, Portsmouth, Suffolk and Hopewell, and the counties of Surry, Isle of Wight, Prince George and Southampton.