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Much has been written on these pages about Virginia Medicaid expansion. All has seemed sincere, much impassioned and some insightful.
My objection to Medicaid expansion is hinged to my basic opposition to political extortion. Our current Virginia situation surely seems like extortion.
We hear from the feds, "Do as I say or I won't give you your money back." How did the states allow themselves to get into this position?
Medicaid is jointly funded by the federal and state governments, with the feds providing policy, guidance and regulation to state governments, which are charged with administering the program and delivering services.
What is potentially more inefficient, wasteful and ineffective than a federally managed program? Answer: A program that has two sets of government paws concurrently mauling the taxpayer.
We find this same joint federal-state extortion funding model in other government domains, including transportation and education.
Why is it used? Simply, the federal partner is needed to finance any program growth, waste and excesses through its limitless ability to produce debt, something no state government can do for very long.
From that flows the argument that we can expand Medicaid in Virginia "without cost," according to some unthinking advocates.
And how is it that the Republicans at the federal level are labeled by the FLS editorial writers as "obstructionist" ["The ACA deadline," March 27] for demanding add-on concessions to pass a national budget, and then are also labeled as "obstructionists" at the state level for resisting the governor's add-on concessions to pass a commonwealth budget?