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Sun Gazette: Va. health-care-reform advocates hope for the best in 2016 Print


Created:  Wednesday, December 2, 2015  10:35AM


The decision by Virginia voters on Nov. 3 to leave Republicans in charge of both houses of the General Assembly may leave proponents of expanded health-care options pessimistic about the 2016 legislative session.

But former state Sen. Mary Margaret Whipple isn't among them.

"We see various paths" to success, Whipple said during a recent meeting with the Sun Gazette.

"We," in this instance, is the Virginia Hospital & Healthcare Association, for which Whipple now works as an adviser. The group represents 107 hospitals and 30 health-delivery systems across the commonwealth.

That organization for much of the past year has worked to engage public opinion to move forward on health-care reform – although not necessarily expansion of the Medicaid system, which has been a non-starter among Republicans in Richmond.

The goal is to "really kind of re-frame this – frame this issue so that people understand it," said Julian Walker, who serves as vice president of communications for the organization.

The advocacy group says that 17 of 37 rural acute-care hospitals have been operating at a deficit. That problem is among the "challenges that can't be ignored" in health care, Walker said.

Those hoping for a more sympathetic ear from Richmond were banking on Democrats' winning control of the state Senate and picking up enough seats in the House of Delegates to send a message to the Republican leadership.

But neither happened: The GOP maintained its 21-19 majority in the upper house and lost a net of just one seat in the lower, where it will in 2016 control 65 of 100 slots.

But Whipple, who represented the 31st Senate District (including much of Arlington) for 24 years before retiring in 2011, expressed optimism that Gov. McAuliffe will propose health-care reforms in his biennial budget (due out by mid-month) and will work to bring legislators into the fold.

"The governor is trying to lead by example and by cooperation," she said, noting that "you just can't predict" whether Republicans will bolt from party orthodoxy to support any proposals from the governor.

Among those who will enter the session with optimism over areas of agreement is Del. Patrick Hope (D-47th).

"There could be quite a bit of health-care activity in the 2016 session," Hope predicted. "There may be an opportunity for compromise – an opportunity for the General Assembly and the governor to work together to solve problems."

Walker said that Virginia could look to a number of states with conservative-trending legislatures that have taken steps to focus on health-care funding, ticking off Indiana, Tennessee, Arkansas and Utah among them. But he cautioned that advocates might want to avoid pushing for Medicaid expansion.

"That term is an automatic turnoff," said Walker, a former political reporter for several Virginia newspapers.

According to the Virginia Hospital & Healthcare Association, hospitals directly employ about 115,000 Virginians with a combined payroll of $8 billion. In 82 percent of rural counties in the commonwealth, the health-care sector is the top employer.

State Sen. Barbara Favola (D-31st), who succeeded Whipple four years ago, expressed concern that the situation for some health-care providers will get worse before it gets better – if it ever gets better.

"More and more rural hospitals are operating with large deficits, and these financial pressures will force layoffs and, in some cases, even closures," Favola said. "Given this scenario, I think it is likely that state dollars will be diverted from other core services to help hospitals close their financial gaps. This approach is not a long-term solution."

Virginia hospitals in 2013 provided $627 million in free or discounted care, up 57 percent in five years.

"Virginia's hospitals are the lifeline of our patients, their families and our communities," said Jim Cole, president of Virginia Hospital Center and chair of the healthcare-association's board of directors.

The combination of government mandates and regulatory burdens "leaves Virginia hospitals financially vulnerable," Cole said.

"The unfortunate reality is, current conditions are squeezing health-care providers," Cole said. "We stand ready to work with lawmakers on solutions to these challenges."

Favola said she hopes it will "eventually become obvious" to opponents of Medicaid expansion that passing up federal dollars is a waste of resources. But she said polarization is likely to remain in place through 2016, as both political parties stake out territory in the presidential election.

(Favola did see one positive, however: "I expect the General Assembly to continue to make progress on securing a more comprehensive safety net for accessing mental-health services," she said.)

Hope said Virginia needs to get "much more serious" about funding Medicaid waivers for those with intellectual and developmental disabilities.

"This is part of the court settlement with the U.S. Department of Justice, where the commonwealth has already been scolded for not meeting the terms of the agreement," Hope said.

The General Assembly convenes in mid-January for a session expected to last 60 days.