There will be plenty of talking but probably little action Thursday when Virginia state lawmakers reconvene to discuss whether the state's Medicaid program should expand.
Republican leaders, who have stymied Democratic Gov. Terry McAuliffe's efforts at expanding Medicaid eligibility since he took office in January, said they are holding a special session to discuss Medicaid expansion because they promised they would. But they've indicated on several occasions that their position on Medicaid hasn't changed.
"I don't think we could have been much more clearer that we think Medicaid expansion is the wrong way to go," House Majority Leader Kirk Cox said Monday.
Several Democrats have panned the special session, saying its pre-determined outcome makes it a waste of time.
"If Republican leadership is determined to double-down on blocking expansion, why call lawmakers back for nothing more than a Medicaid charade?" Democratic Party Chairman Dwight Jones said in a statement.
But McAuliffe said he remains optimistic that Republican lawmakers will change their minds.
"Virginia should be a leader on health care," McAuliffe told reporters Thursday morning. "We should be an engine, not a caboose."
Under the Affordable Care Act, states decide whether to expand Medicaid, with the federal government promising to pick up most of the cost. Whether to expand public health care to about 400,000 low income able-bodied adults has been the key issue of McAuliffe's tenure. The governor and Democratic lawmakers say the state's economy needs the infusion of federal funds to help cover the cost of the care already being provided to the state's poor.
But most Republican lawmakers opposed expansion, saying they don't believe the federal government will be able to keep its promise to pay and the state can't afford a large scale increase of an entitlement program.
McAuliffe conceded earlier this month that is ability to expand Medicaid on his own is limited. He unveiled an alternative plan aimed at encouraging adults and children already eligible for publicly subsidized health care coverage to enroll in various programs. The state and the federal government would also each pay about $80 million a year to cover the costs of new coverage for 20,000 uninsured residents with a severe mental illness.
But the governor has said he's not given up on expanding Medicaid and urged lawmakers to pass a modified expansion plan proposed by Republican Del. Tom Rust that emphasizes the use of private insurers. Rust is one of a handful of GOP lawmakers who have voiced support for expanding publicly funded health care. GOP House leaders have previously voiced opposition to Rust's bill and rejected similar modified Medicaid expansion plans.
Top Republican lawmakers have defended the special session, noting that lawmakers will also vote on a bipartisan budget plan to cut the state budget and will vote to fill several judicial positions around the state.
"These are all important tasks worthy of our time and attention," House Speaker William J. Howell said in a statement. "Anyone who says otherwise is being counterproductive in an attempt to score political points."