On Monday, Governor Terry McAuliffe has scheduled a major announcement concerning ObamaCare expansion, the week prior to the General Assembly meeting to deliberate on that issue.  A topic that has been discussed ad nauseum for more than a year, much of what you’re likely to hear or read in the coming days will leave out some of the most important elements of the issue. While the topic of health care and expansion are multilayered and incredibly complex, and real solutions are needed, there really are two main points about expansion that you must remember, and share with others:

The federal government is trillions of dollars in debt.  Trillions.  Expansion will, despite the promises from the government, cost billions more.  To say we can’t afford more government health care is a vast understatement. Medicaid is a federal entitlement program, which means the feds write all the rules.  They may grant “waivers” for minor details, but the bottom line is it’s their program and they are going to run it regardless of what the state wants Which makes this article in The Federalist all the more compelling.  The narrative being pitched by the mainstream media and expansion proponents is that the Obama administration is more than willing to “cave” to state Medicaid reform ideas in order to expand the program and if you’re not willing to expand, well you’re just a big meanie who hates poor people.

Of course, nothing could be further from the truth, but it’s not like proponents of expansion will let the facts get in the way.  The reality is, even in states that have expanded their program using “reform” ideas or by calling expansion “alternatives,” the money is coming from the federal government, the rules are coming from the federal government, and it’s the federal government that continues to go into debt.  Oh, unless the “reform” isn’t paid for by the feds, then it’s paid for by the state.  And with Virginia’s wonderful budget situation – you know, the $6 billion deficit already staring us in the face over the next two years – taking on more entitlement programs and spending more money has got to be a good thing, right?

There are real health care reforms that could actually help drive down some of the costs, but most can’t be implemented because of federal rules.  ObamaCare just made the situation worse.  The states, once called “incubators of democracy” where new and alternative ideas can be tested, are now simply at the mercy of federal rules and money.  So, when anyone says, “If you’re against Medicaid expansion, what’s your plan,” remember, the federal government won’t give us the freedom to have a plan.  It’s their way or no way.

Consequently, anyone who thinks that Virginia can sufficiently reform Medicaid to make it an efficient system of delivering health care simply isn't paying attention.  Until the federal government ends its stranglehold on health care, solutions will be nearly impossible to find.