5 ways health care is shaping the debate in this year’s General Assembly election

Published: Oct. 28, 2019 at 9:16 AM EDT
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This year’s General Assembly elections have led to sharp exchanges between Democrats and Republicans on health care, which poll after poll has shown voters view as a top issue.

But with candidates on both sides of the aisle campaigning on promises to ensure access to affordable care, it’s not always easy to discern exactly what’s at stake when voters head to the polls on Nov. 5.

Most of the debate has focused on what’s already happened: Medicaid expansion

The General Assembly passed a bipartisan compromise last year which, at last report, enrolled more than 330,000 people. In some localities, especially in southern Virginia, that’s led to almost 10 percent of the population gaining coverage.

Democrats, who unanimously supported the move, are stressing expansion as a major victory, noting that it only followed massive gains in the 2017 election that put them two seats shy of a majority in the House of Delegates.

Debate remains on short-term insurance plans and drug prices

Outside of Medicaid, candidates have occasionally sparred over support for short-term insurance plans, which some Democrats deride as junk plans and some Republicans back as an affordable option that should be expanded.

A few candidates have also focused on prescription drug prices.

A fight over health industry campaign contributions

One element of the health care debate that’s played an outsized role in campaign literature: campaign contributions from the health care industry.

Democratic candidates around the state have fired off a steady stream of campaign mailers attacking their Republican opponents for accepting donations from companies and executives in the healthcare field, tying the contributions to votes candidates made against expanding Medicaid and short-term health plans.

Republicans note that Democrats around the state, and the party’s caucuses as a whole, have taken substantial contributions from the exact same sources.

Many of the big health care debates aren’t partisan

There’s disagreement within both the Republican and Democratic caucuses about the best approach to addressing surprise medical bills, which has pitted health insurance interests against hospitals and doctors.

There’s also lingering bi-partisan disagreement about how hospitals are licensed – the long-debated Certificate of Public Need, which determines what kinds of health care facilities can open where.

Northam hints at future action

In an executive order earlier this month, Northam issued a broad — but not particularly detailed — directive to his staff to come up with ways to address health care access and affordability in the budget proposal he will introduce next year.

Northam’s office said the work would be guided in part by recommendations made earlier this year by a work group on health care.


The Virginia Mercury is a nonpartisan, nonprofit news organization covering Virginia government and policy.