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Session Newsletter (Feb. 25, 2014)

February 25, 2014 by Creigh Deeds

Nearing Sine Die

The 2014 session of the General Assembly is rapidly moving toward the scheduled adjournment on March 8. Both houses passed competing budgets this past week and bills are headed to conference.

On Thursday the House and the Senate passed out their respective versions of the biennial budget. As with all legislation, the budget bills must be approved by the other chamber. Every year, the House and Senate insist on their amendments and send the budget to a committee of conference. The General Assembly is expected to finalize the budget for fiscal years 2014-2016 before the scheduled adjournment, but the deliberations may stall this year over Medicaid.

Medicaid Expansion

At least twice this session I have used this space to talk about Medicaid expansion and about the Senate’s approach, Marketplace Virginia. A couple of things need to be clear whether or not we expand Medicaid in Virginia. First, individuals and Virginia businesses will pay additional taxes to the federal government. Second, Virginia hospitals will experience reduced Medicare payments from the federal government and must continue to provide treatment to the uninsured. The gap between the cost of providing care to these patients and the reimbursement will grow into the hundreds of millions of dollars.

The primary hang-up between the budget advanced by the House of Delegates and the Senate of Virginia involves these issues. Marketplace Virginia is an attempt not only to provide insurance coverage to about 285,000 Virginians but also to recapture almost $2 billion in federal taxes Virginians are paying. The Senate proposal recognizes the reality of the federal actions and tries to take advantage of it. The House budget rejects that reality and instead uses millions of state tax dollars to reimburse hospitals for the Medicare cuts imposed at the federal level. Under the House plan, Virginia taxpayers will pay for Medicaid expansion while nobody in Virginia will receive any benefit under that program. Virginia taxpayers will also be asked to pay a second time for the cost of Medicaid expansion through the reimbursement program to the hospitals.

Some of my colleagues in the Senate who have been philosophically opposed to the Affordable Care Act recognize that it is the law and believe we should put the law to work in order to benefit as many Virginians as possible. Enacting a market-based insurance plan to expand coverage to the uninsured is more fiscally prudent than doing nothing. A rejection of Marketplace Virginia is not a vote against the Affordable Care Act. At best it is a symbolic gesture, but the action will cost Virginians real tax dollars. The ongoing discussion about health care is at the heart of why a budget will likely not be agreed to on time.

Mental Health Policy Reform

There was some progress on my efforts to make changes in the mental health laws of Virginia. Mental health has always been an important issue to me throughout my legislative career. The community services boards, particularly Region Ten and Alleghany Highlands Community Services, have made great strides over the years in improving services, and the staff has kept me abreast of the needs in our communities. Family members of institutionalized loved ones have been vocal advocates about Virginia’s abysmal ranking for spending in these vital areas. Particularly after the tragedy at Virginia Tech in 2007, I have been involved in efforts to ensure that the laws will be responsive to the needs of all Virginians.

I did not ask to be more involved than that, but my circumstances have made it necessary for me to be more directly involved in reforming our mental health laws. To that end, I introduced a number of bills this year. I can report that my bills relating to crisis intervention are moving along. The legislation requiring the Department of Behavioral Health and Developmental Services to reexamine qualifications for intake agents and establish a data base for psychiatric beds is still under consideration in the House. Disagreement remains about how long we should extend the emergency custody order period. I am confident that we will have a satisfactory bill emerge from conference. Importantly, the study resolution that asks for a two- year comprehensive examination of the mental health system appears headed for passage. It has been amended to specifically include the effective re-institutionalization of those with mental illness in our jails and prisons. Needless to say, this study is the vehicle by which we hope to make significant long-term changes in the mental health system. I am convinced that through this work we can improve the quality of people’s lives for years to come.

It continues to be my pleasure and distinct honor to represent you in the Senate of Virginia. If I can be of service, do not hesitate to contact me at PO Box 396, Richmond, VA 23218, [email protected], or (804) 698-7525.

Session Newsletter (Feb. 14, 2014)

February 14, 2014 by Creigh Deeds

Crossover and Medicaid Expansion

This past week the General Assembly saw the crossover and lots of chest thumping. Both sides, Republicans in the House of Delegates and Democrats in the Senate, claimed to be the source of all things moderate and reasonable. The proof, however, is in the pudding, and people can make their own judgments. The big hang up at this point remains from the opening day of session: Medicaid expansion.

Paying for Medicaid Expansion

As explained in this space before, Medicaid expansion is an optional part of the Affordable Care Act. Payment for expansion, however, is not optional. Funding comes from federal taxes. People are already paying increases in taxes on insurance premiums and in other areas. Virginia taxpayers will continue to pay those taxes whether or not we expand Medicaid; however, if we don’t expand in Virginia, our taxpayer dollars will be spent to provide coverage to residents in other states. Virginia loses in excess of $5 million in federal funding every day that we don’t expand Medicaid.

Last week Senator John Watkins, a Republican from Powhatan, revealed a new approach to Medicaid expansion. His proposal, which would need to be approved by the federal government, would allow us to put our own brand on expansion and provide coverage to an estimated 285,000 people. The plan, Marketplace Virginia, requires recipients of the new coverage to pay a premium, just as they would if they had private insurance. The proposal also includes language we inserted into the budget last year that says if federal funding ever dips below 90 percent of the cost of expansion, Virginia will be allowed to withdraw. As explained before, under existing law, the federal government will pay 100 percent of the cost of expansion for three years, reduced to 90 percent in the sixth year of expansion. The premiums will be collected to apply against the state’s share of the cost.

Members of the House of Delegates argue that reforms to Medicaid must occur before expansion. Two of the primary concerns, however, are already written into the law. We already establish a minimum 90 percent funding level, and we require the payment of premiums. Requiring some form of financial responsibility on the part of the insured is a significant reform. What’s more is the unbelievable pressure that the cost of providing for the uninsured puts on our health care system. That pressure has shut down hospitals in Virginia and in other parts of rural America. Expansion of Medicaid will provide the necessary funding to keep rural hospitals open.

Impact of Medicaid Expansion on Treatment of Mental Illness

And, important to me, expansion of Medicaid requires equity between the treatment of mental illness and other illnesses. This will pump over $200 million a year into Virginia’s treatment for mental illness. Without question, this will raise the level of mental health care higher than we have ever had in Virginia. Expanding insurance coverage, passage of the omnibus mental health bill, and a comprehensive review of our system has the potential to bring much needed transformations in the delivery of mental health care in Virginia and put the Commonwealth in a leadership position among the fifty states in the treatment of those who suffer mental illness.

As Virginians we should not expect to be any less than leaders.

I continue to be overwhelmed by the kindness and the support I receive from constituents, people around Virginia, and people all over the country on a daily basis. It remains my distinct honor to represent you in the Senate of Virginia. If I can be of service, do not hesitate to contact me at PO Box 396, Richmond, VA 23218, [email protected], or (804) 698-7525.

Session Newsletter (Feb 7, 2014)

February 8, 2014 by Creigh Deeds

The 2014 session rolls on, and we are nearing crossover. Crossover is the time when the Senate must complete work on bills introduced in the Senate, and the House must complete work on bills introduced in the House. It’s called the crossover because after it occurs, the bills cross over to the other house for consideration.

Virginia Budget Issues

Transportation

As usual, the budget is the major piece of work to be completed in this session of the General Assembly. In past years, transportation has been the topic at the top of the agenda. With the passage of the comprehensive transportation package last year, there are more arguments over spending priorities and how to balance the budget. With that said, the transportation plan last year has not raised nearly as much money as anticipated because last year’s numbers were built on the presumption that the price of gas would continue to rise. The good news for consumers is that the price of gas, though high, has remained fairly stable.

Expansion of Medicaid

Not surprisingly, the big issue this year with respect to the budget is the expansion of Medicaid. As outlined in this space a few weeks ago, I think expansion would be a good deal for Virginia. It would provide health care, including mental health service, to between 200,000 and 400,000 currently uninsured Virginians; and it would create a significant number of new jobs in Virginia. The federal government has committed to funding 100 percent of the cost of Medicaid expansion for the first three years and at least 90 percent in subsequent years. To me, it’s a no brainer: it is the right thing to do, and it makes good economic sense. A proposal to create a Virginia Marketplace to provide coverage for these individuals has been advanced in the Senate. The General Assembly is far from reaching a consensus on this issue, which risks tying up the budgetary process for a considerable period of time.

Contentious Legislative Proposals

A number of controversial topics have been debated this session that generated a lot of phone calls and emails. Among the most contentious measures are:

Sunday Hunting

This year a bill was fashioned by Senator Phillip Puckett and others to allow Sunday hunting on private property by the owner of the property or those to whom he gave permission. I have long resisted voting for Sunday hunting because I think there are things to do outside on a Sunday other than hunt. In Bath County, where I live, hunting remains a popular activity. In the fall, Sunday is the only day that you can participate in other outdoor recreation, like trail riding or hiking, without coming across hunters in the woods.

Boating on Non-Navigable Streams

Senator Dave Marsden introduced a bill this year granting anyone the right to float on a stream with a drainage area of at least seven square miles. The bill was framed somewhat innocuously but would have allowed, from my perspective, floating on just about every stream in Virginia. Because I was concerned that this approach would have negatively affected some people’s property rights and would have provoked confrontation, I voted no.

Death Penalty

Currently there is a bill pending from Senator Bill Carrico that would mandate execution by electrocution, a method that is optional under current law, if the chemicals for lethal injection are not available. Starting in 1994 Virginia joined the trend of performing executions by lethal injection. Today, some of the drugs that have been used to make the cocktail for the lethal injection are in short supply. I understand why Senator Carrico introduced the bill. However, there are only four states that currently allow the use of the electric chair. I am inclined not to support this legislation. I think we need to make sure that our statutes are constitutional, and I am concerned that this bill will actually weaken our death penalty statute.

Ethics Reform

The high profile case involving former Governor Bob McDonnell generated a great deal of interest and legislation pertaining to our ethics laws. The bill moving through the Senate would create the Virginia Conflict of Interest and Ethics Advisory Council, expand reporting requirements to include gifts to children, require semi-annual reporting of lobbyists and elected officials, and cap tangible gifts to legislators at $250, among other provisions. The bill is pending on the Senate floor as we debate amendments. While the bill does not go as far as some would like, the provisions are an improvement over current law.

Mental Health Policy Reform

A large portion of my work continues to be in the area of attempting to reform our mental health laws. Two of my proposals, Senate Bills 260 and 263, and legislation sponsored by others have been merged into one bill. The omnibus bill will require subjects be held up to 24 hours under an emergency custody order, create a database of available psychiatric beds, and ensure people in need of hospitalization cannot be “streeted” by establishing state hospitals as providers of last resort. That bill is currently on the floor of the Senate, and I expect to move it to the House by next week. The resolution creating a joint subcommittee to study mental health services passed the Senate and is pending in the House Committee on Rules.

The response to my legislative work on mental health has been overwhelming. People from throughout Virginia and the United States have shared their stories and reached out to me for help. Getting in touch with your elected officials and voicing your concerns is critical to effecting change. The Governor’s Task Force of Mental Health Services and Crisis Response will continue to meet throughout the year. You can submit public comment here.

It continues to be my distinct honor to serve you in the General Assembly. This will continue to be a busy session for me, and I look forward to your input throughout the process. Concerns, questions, or requests should be directed to my office at: PO Box 396, Richmond, VA 23218, [email protected], or (804) 698-7525.