When John Fredericks told Governor McAuliffe he’d recommended him to Donald Trump as Secretary of Commerce, McAuliffe responded that he’s not leaving office early for anything. He might rethink that after this legislative session, but for now he’s focused on jobs, Medicaid expansion, public safety, and invigorating Virginia's exports.
On a recent visit to Virginia Trump, answering a question from the press, remarked that he thinks Terry is a great Governor. It seems that John Fredericks agrees, at least as far as the Governor’s enthusiastic efforts getting companies to come to Virginia and creating jobs. In fact, with the exception of Executive Order 50, Fredericks seems to be a fan himself and said as much in an interview Friday.
On two issues that are related, Medicaid expansion and Certificates of Public Need (COPN), Fredericks’ and McAuliffe’s positions appeared to intersect as do the interests of Virginians on both. Unfortunately, Republican members of the General Assembly have placed politics above the interests of their constituents. Fredericks summed up the two sides of the COPN repeal argument: opponents say repeal would weaken the healthcare system; proponents say it would promote competition. McAuliffe pointed out that he requested the Task Force that is studying COPN. Medicaid expansion or the lack thereof is an essential factor in the design.
That Task Force headed by Eva Hardy has been meeting for over a year. McAuliffe says that at the macro level, coming from a business background, he is always for competition. But he also recognizes the charitable needs we have. He wants to do what is in the best interests of healthcare provision. While he believes competition is good, it has to be balanced against the needs of the citizens of Virginia.
Fredericks pointed out that COPN repeal will put hospitals in rural Virginia at risk. He asked point blank if the bill comes to the Governor will it be vetoed. Governor McAuliffe deferred, saying he’d have to see the bill, but that he too is concerned what a total repeal of COPN may do to our rural hospitals. Do we need reforms in COPN? “You bet we do,” remarked McAuliffe, “That’s why I asked for this task force.”
COPN authorizations are considered in review cycles that are separated into 7 different batch groups. The batch groups are:
- A. General Hospitals, obstetrical services, neonatal special care services, general capital expenditures
- B. Open heart surgery cardiac catheterization, ambulatory surgery centers, operating room additions, transplant services
- C. Psychiatric facilities, substance abuse treatment, mental retardation facilities
- D. Diagnostic imaging facilities and services
- E. Medical rehabilitation beds and services
- F. Radiation therapy, gamma knife surgery and linac based SRS, lithotripsy, diagnostic imaging equipment may be included in an application with radiation therapy
- G. Nursing home facilities and bed additions, nursing home capital expenditures
Hospital care is not an unregulated free market. Recognizing public need, hospitals are required by law to provide substantial free and discounted care in the form of what Fredericks characterized as unfunded mandates. That demonstrates a fundamentally flawed misrepresentation of the requirement. Typical of the view from the right, it ignores the fact that laws grow from moral, cultural, and social factors. More often than not, as in the codification of common law, laws and regulations capture the aspects of society deemed worthwhile. In this case it captures the Hippocratic responsibility to deny no one care and the obligation for charity.
According to Fredericks, some say that legislators are pushing COPN repeal to punish hospitals for backing Medicaid expansion. McAuliffe reacted to that by saying that he has worked very hard on this and tried to do it in a bipartisan way. The hospitals have now “stepped up to the plate” he said, referring to the offer to cover the 10% state match funding requirement that begins next year. According to McAuliffe, for every dollar the hospitals invest they will get seven to nine in return. 17 of our 27 rural hospitals are operating in the red. He points out that hospitals in the rural communities can be the largest employers also.
”Whether you like healthcare, whether you like the President it doesn’t matter anymore, the Supreme Court’s ruled it. We have the ability, John, to bring $2.4 billion back, create 30,000 jobs, provide healthcare to 400,000 folks, save our rural hospitals. And John, we can do this with no obligation to the state. – Governor McAuliffe
(Note that the Governor errs in saying he can “bring back” the money that Virginia has passed up in previous years; but the funding going forward will have the suggested economic and coverage benefits.)
McAuliffe stated that when he pays taxes he wants it all back. He pointed out that Virginia is receiving $120,549,000 for resiliency to protect against sea level rise. He wants to bring as much of Virginians’ federal tax dollars back as possible.
One has to wonder what in GOP minds makes funding that combats climate change less objectionable than funding that improves Virginians’ lives.
"I am a very pro-business, fiscally conservative Democrat. I am socially progressive. I always believe government ought to be out of people’s personal lives."
He pointed out that Louisiana recently expanded and that the tea party governor of Kentucky who ran on repealing expansion has decided that is not a good plan. Medicaid expansion is right for the shareholders of Virginia: the taxpayers.
Regarding Senator Chap Peterson (D-Fairfax) wanting to save Republicans from themselves: The Governor agrees with both Chap Peterson and Donald Trump on the loyalty oath and he would sign the emergency legislation. “If you get somebody to vote in the primary and you can’t hold them for the general election, no offense, shame on you. Obviously your message or your candidate’s not working. Don’t make them sign some foolish oath.”
Turning to banning guns through what Fredericks termed “executive fiat” Fredericks said that has personally affected him. Because he has to leave his Glock in his car in downtown Richmond, he argued he is defenseless.
”If somebody is going to come in there to wreak havoc and shoot up the place, they’re not going to say “Well look, I can’t come in this place because there’s a sign on the door from the Governor of Virginia.” – John Fredericks
Governor McAuliffe pointed out that before he signed Executive Order 50, he consulted with law enforcement. The State Police, the state’s Chiefs of Police, the Sheriff’s Departments all agreed that personal weapons were just not needed in state offices. This he classifies a common sense and he pointed out that nobody is taking anyone’s guns away.
“I am not trying to stop anyone. If you are a lawful, law-abiding citizen, you can go in and buy whatever you want on your handguns, John. You can do that tomorrow. I am for that. Buy as many as you want. Fill up your house. I’m fine with that. But you know what? If we can stop a couple of folks, those that have a criminal record, then we ought to do that. That’s not some far outer space idea; I’m sorry.”
In closing, McAuliffe returned to the theme that he believes got him elected: jobs. There were $9.8 billion in federal spending cuts during 2011 - 2013. Most of that affects Northern Virginia. There’s about 15 million square feet vacant in Crystal City as a result of defense cuts. This will happen again in 2 years when sequestration begins anew. This is why the Governor is focused on diversifying the economy. The 565 economic development projects totaling $9.3 billion in capital investment during his time in office speak for themselves.
The recent trade visit to Cuba was a footnote. Virginia has been doing business in Cuba for 13 years. McAuliffe believes we can increase our agricultural exports dramatically. In return we can consume some Cuban rum and cigars to get that trade flowing. And he just returned from Oman and Kuwait where he got the poultry ban lifted. Virginia apples are now being sold in India. This is what McAuliffe believes he was elected to do.