The historic transportation package that passed both houses of Virginia’s legislators received the most attention at the Roanoke Regional Chamber 2013 legislative wrap-up Friday. Those attending the early morning breakfast included Senators Steve Newman and Ralph Smith who both voted against the package along with Delegate Greg Habeeb.
Senator John Edwards and Delegates Charles Poindexter, Chris Head and Onzlee Ware (not participating) voted for the transportation package. Edwards said an Amtrak train would be picking up passengers in Roanoke by 2016. “Buy your ticket on the Internet, hop on the train, go to sleep then wake up in Boston,” he said. Delegate Head said the funding for passenger rail would help businesses who complain about the difficulty of access to the Roanoke Region.
Senator Smith rejected the higher tax rates especially the .3% increase in the sales tax targeted for transportation. He called it “the creeping factor” with Virginia creeping out of being a low tax state compared to states like Connecticut, Massachusetts and California.
Edwards said the second most important thing for Virginia is the expansion of Medicaid where up to 400,000 more people would be covered. The legislation would also create 30,000 jobs and save the state’s contribution to charitable care according to Edwards. Senator Edwards has been appointed to the Health Insurance Reform Commission.
Joyce Waugh, President and Secretary of the Roanoke Regional Chamber of Commerce said, “the transportation package is the most momentous thing to happen in recent memory from the General Assembly session.” Previous governors had failed and though it was not to everyone’s liking “the fact that it happened is truly remarkable,” she said. “It had to happen – people are dying on the roads. Business is being impeded and if business can’t get what they need here, eventually they go elsewhere.” It’s one of the legs of the three-legged stool with the other two legs being a strong educated skilled workforce and a good infrastructure. “Those are the underpinnings,” she said.
Waugh says the Chamber supports Medicaid expansion because of the services it would provide to uninsured workers. The insurance will be mostly paid by the federal government. “People don’t know what is coming with health care and don’t really know how to react to that – that’s one of the biggest things we hear from our businesses.”
Delegate Poindexter was adamant that Medicaid reform takes place before any expansion. Reforms that would allow pilot programs and manage patient care by having general practitioners refer patients to specialists if needed. The downside is that the number of general practitioners is not sufficient to carry the increase in patients.
“We’re talking about a personal responsibility,” said Poindexter. “People have to buy in like eating a proper diet, staying off drugs and reducing alcohol consumption. They need a dog in the fight.” A favorable health outcome for the patient is the goal and the patient bears some responsibility for that. “We can’t force them,” he said, “but with an education program to encourage them to get involved in the process of their own health.” He said the administration of care shouldn’t be a straight fee for service but should be based on the outcome of the service provided to the patient.
“We are insisting on reform before we expand,” said Poindexter.”Until we’re satisfied that the reform measures are put in place just adding more people to the system does not work.” The outcome for the patient is diminished and the cost is too high for taxpayers. Hospitals only get 62 cents on the dollar while caring for Medicaid patients so hospitals tend to release them too soon, Poindexter said.
“No, I can’t buy the argument that it is free [federal] money – it’s still our taxpayer money,” asserted Poindexter.
– By Valerie Garner
