Five of my amendments to the budget passed on Tuesday, and I thank you for all your calls and emails! Because the Senate recessed until April 7, the budget impasse continues.
On Tuesday, March 25th, delegates were presented with printed versions of two budgets: HB 5001, amending state spending through June 30, 2014 and HB 5002, funding Virginia’s government from July 1, 2014 through June 30, 2016.
These two documents were 800 plus pages in ten point type on letter size paper! We had roughly one and a half hours to review HB 5001 before we voted, and three hours to examine HB 5002 and draft amendments to sections of the budget. This made it difficult to complete a thorough and accurate review!
As a result, while I initially voted for HB 5001, I continued to study the massive bill after the vote. Delegate Mark Berg and I found provisions related to Medicaid “Reform” and other vague language related to Medicaid expansion, so, while I was initially recorded as a “yes” vote, I determined that I should file a “no” vote afterwards for the public record as did Delegate Mark Berg who also continued to digest the contents of HB 5001 after initial passage.
I also offered a floor amendment to the two year budget (HB 5002) to restrict Virginia’s Medicaid agency from writing regulations which they are required to do by the Obama Administration for current Medicaid recipients in such a way as to add new recipients. I wanted to close this loophole and I succeeded (with your help!) My amendment passed 68-31.
Language contained in HB 5002 limited any Medicaid expansion to theoretically end on June 30, 2016 giving the false impression that Virginia could unilaterally back out of Medicaid expansion after a two-year pilot program.
Because there are no provisions in the Obamacare regulations promulgated by the U.S. Department of Health and Human Services, or any actions by the President to provide for a provisional expansion of Medicaid, I successfully amended the bill by striking this language. My second amendment passed 68-31.
There are two ways that Medicaid expansion can be funded in the current budget. One is a provision by which the Medicaid Innovation and Reform Commission (MIRC) announces that all reforms have been completed and once they certify it, Medicaid expansion is funded. The second way Medicaid expansion can be funded is through the use of general appropriations language directing how excess funds are to be spent, even in cases where such language was not originally inserted in the budget to specifically provide funding for Medicaid expansion.
However, I was advised by legal counsel twenty minutes before the session that the effect of my amendment to remove the first provision might allow the Governor to use the second approach to fund Medicaid, even though the language was not specific to Medicaid expansion. Therefore, I withdrew my third amendment striking the MIRC funding provision. By leaving the MIRC funding language provision in the budget (for now) Governor McAuliffe is precluded from funding Medicaid expansion on his own through the use of excess funds.
Last year I voted against the budget because it contained similar provisions authorizing MIRC to “reform” Medicaid as a pre-condition of expanding it. That made it a poison pill for me then, and it remains so now.
As a result of all this, I voted “no” on final passage of HB 5002 because the so-called Medicaid “reform” commission was still in the budget. I filed the following statement which will appear in the House Journal explaining my “no” vote on HB 5002.
“I object to vesting the 10 member Medicaid Commission with ostensible authority to authorize the appropriation of funds to implement, for however long, an expansion of Medicaid, which I believe violates the Constitution of Virginia as an improper delegation of authority to a subset of the General Assembly.”
In other matters relating to the budget, several of my non-Medicaid amendments had been previously adopted and were already in the budget to prevent any state funding for Planned Parenthood, abortions of disabled children or any efforts by Governor McAuliffe to suspend or modify Virginia’s abortion clinic regulations.
Again, I am grateful for your efforts to contact members of the House of Delegates to support my amendments on your behalf. As the Senate has not acted on either budget, the budget impasse continues, so please continue to call and write your representatives.
Last fall, Governor Terry McAuliffe said the threat of a government shutdown shouldn’t be used as a bargaining chip in negotiations over the health care law. Now, he and the Democrats in the Virginia Senate are holding Virginia’s budget hostage to Obamacare, threatening to hold up funding for our teachers, schools, firefighters, police officers and local governments. This is wrong! Virginia should pass a clean budget with no strings attached. The debate for expanding Medicaid under Obamacare should be a separate issue.
I urge you to contact Governor McAuliffe, your Senator and your Delegate to ask them to stop holding the budget hostage to Medicaid expansion. If you don’t know who your Senator is you can find out here.
The Medicaid expansion has been touted as a way to get “free” money to help underserved Virginians. We all know there is no such thing as a free lunch. Accepting whatever Federal taxpayer funds Virginia would receive would only be for a maximum of 3 years and then Virginia would be required to take up the slack to the tune of billions of dollars. The federal government is hemorrhaging money and even if I thought expansion of Medicaid were a good idea I do not believe adding to our national debt is in the best interest of any Virginian.
Medicaid is already the largest expenditure that Virginia has in its budget. If we were to take on the additional costs associated with this expansion taxes would have to be raised and reductions would have to be made to important programs like transportation, education and many others.
Some Democrats have insisted that if the Federal government were to stop paying their share of the funding for expansion that Virginia is always free to back out. Nothing could be further from the truth. There is no provision in the Obamacare law or in the regulations promulgated since then that would allow any state to back out of this contract.
In addition to all of this Medicaid is currently riddled with fraud. Last year Virginia Democrats agreed to defer any action with regard to Medicaid expansion until action was taken by the Medicaid Innovation and Reform Commission and now they are going back on that pledge. States that have undertaken reforms have found millions of dollars in fraud. If we fix the broken system there will be additional funds to help those who actually need it without expansion or taking on this additional burden for Virginia taxpayers.
Please contact Governor McAuliffe, your Senator and Delegate to urge them not to support Medicaid expansion in the budget!
Contact: Delegate Bob Marshall 703-853-4213 or 571-409-0588
MANASSAS, VA -The decision issued by federal district Judge Wright-Allen appropriately issued in the cover of darkness is a syllabus of errors, a compendium of ineptitude, and a farce claiming authority. Legislating through the Courts against the will of the people is lawless disregard for our representative form of government.
Federal Judge Arenda Wright-Allens’s decision:
Confuses the Declaration of Independence with the United States Constitution (Page 2). Judge Wright-Allen took an oath to uphold the Constitution and yet she seems to be unable to even identify it;
Vests the judge’s opinion with more social and legal importance than that of the 1.329 million voters who approved the Marshall-Newman Marriage Amendment;
Makes no clear definition of Marriage, though Judge Wright-Allen makes claims about it;
Provides no legal distinctions or reasoning why her version of “marriage” must be limited to only two persons;
Rules that denying marriage to homosexuals is the same as denying interracial marriage. Therefore race is equivalent to sexual behavior;
Equates the centuries long struggles of Americans of African descent in this country with the life shortening and health compromising behaviors associated with the LGBT lifestyle;
Tries to equate segregationist practices previously prevalent in Virginia providing for separate accommodations for hotels, restaurants and water fountains, denial of voting or educational opportunities are equivalent to the experiences of the modern LGBT community.
Clearly misreads the Loving vs. Virginia Supreme Court decision which affirms the possible procreative aspect of marriage that is only between a man and a woman;
Cites the Fourteenth Amendment as justification for striking down Virginia’s Marriage Amendment even though at the time of its ratification sodomy was illegal in all but five states;
Fails to explain how homosexual activity can be a predicate for so-called same sex marriage, but can disqualify such participants from donating blood;
Has pretentions to know more about marriage than Moses and Christ;
Assumes that anyone who disagrees with her is motivated solely by hate and visceral animus of the LGBT community;
Manassas, VA – Delegate Bob Marshall spoke on WTOP News February 2, 2014 discussing the Virginia Attorney General Mark Herring’s refusal to defend Virginia’s Constitution Marriage Amendment, also known as the Marshall Newman Amendment.
Previously, Sen. Mark Herring voted for the measure that was approved by 1.3 million Virginians in 2006. It garnered just over 57% of the total vote. Source: Wikipedia
Richmond, VA – Today Delegate Robert G. “Bob” Marshall (R-13) and Delegate Patrick A. Hope (D-47) joined together and to call on both the General Assembly and Governor McAuliffe to take decisive action for the decades of policy that sterilized thousands of Virginians. Delegate Marshall has introduced HB 74, with Delegate Hope as the Chief Co-Patron, which establishes the Justice for Victims of Sterilization Act to provide compensation to persons involuntarily sterilized between 1924 and 1979 in Virginia.
Delegate Marshall stated “Beginning in 1924, Virginia, to its disgrace, provided a model for Nazi eugenics sterilization statute. Now in the 21st century we must seek to redress this as best we can. Many of the victims of this policy of involuntary sterilization are still alive and suffering the effects. Under eminent domain, government is required to compensate citizens for taking away property; how much more should it compensate for taking away the ability to have a family?”
Hope added, “It’s now time to write the final chapter in this shameful and repugnant part of Virginia’s history. What we’re asking for goes well-beyond just simple words of regret. We need to set an example and take full responsibility for our actions so that the healing process can finally begin.”
Also in attendance was Mr. Lewis Reynolds who was forcibly sterilized at the age of thirteen. (Note a brief bio for Mr. Lewis is included below.) Mr. Reynolds commented that ““I always wanted children. My wife and I would cry because I could not give her children. I sometimes still will cry when I am alone. I wanted children very much. It is hard for me to think that they thought I was worthless.” He adds, “It would be right if they [Virginia] paid for what they took from me. [Still] I served my country and would have died for my country.”
Mark Bold, the Executive Director at the Christian Law Institute stated, “Virginia, in its official capacity, aggressively sought to eliminate entire classes of our citizens, those the Commonwealth considered “unfit” and “defective,” in a cruel, selfish and materialistic effort to create a superior human race. An apology and a pat on the back will not provide the relief that is necessary to the few remaining living survivors. Their injury is ongoing and continues to exist; therefore the debt to these victims still exists in a moral sense.”
Victoria Cobb, the President of the Family Foundation of Virginia said, “Virginia has apologized for eugenics, but that’s little comfort to those few surviving victims who had their ability to have children taken away from them by an atrocious government act. The idea that the government can deem some worthy of life and others not should be revolting to every American. And while this small amount of money cannot begin to undo the wrong, it is one way to hold a government accountable for its actions and, hopefully, to prevent anything like this from happening again.”
Jeff Caruso of the Virginia Catholic Conference noted, “Virginia’s policy of forced sterilization was inhumane and must be repudiated in the strongest terms. While no amount of money will ever repair the harm done or adequately compensate the victims for their loss, the Commonwealth finally should provide some restitution as a matter of justice.”
Jamie Liban, the Executive Director of the ARC of Virginia also spoke.
Mr. Lewis Reynolds, 86, a Marine Corps veteran of 30 years, fought in two wars (Korean and Vietnam), married for 47 years, forcibly sterilized at 13. Mr. Reynolds first wife left him because he could not give her children. Mr. Reynolds was sterilized at the Central Virginia Training Center (formerly Virginia Colony for the Epileptic and Feeble Minded) because they said he was epileptic; in fact he was recovering from an injury he received when a rock hit him in the head.
I URGENTLY NEED YOUR HELP!! My HB 39, to provide an alternative to Medicaid expansion by providing free health care to the indigent through volunteer doctors is set to be killed in Committee tomorrow. There are big money interests that want Medicaid expanded, and my bill would get in their way!
When I received notice that HB 39 would be heard tomorrow, Delegate Landes and I asked for a short postponement as a courtesy to the doctors who need to rearrange their schedules in order to testify on behalf of my bill. I was told by Subcommittee Chair Delegate Habeeb that I could reschedule. Within an hour Del. Habeeb told me the bill would be heard tomorrow!
My bill is being opposed by the Trial Attorneys. Under HB 39, if doctors donate four hours weekly of free care to the indigent in exchange for their service, the Attorney General’s office would defend them against lawsuits in their private and charity practices. This would lessen the need for malpractice insurance.
Few doctors serve Medicaid recipients currently because of the high costs. Adding 425,000 new Medicaid recipients to the present one million will further burden the system.
During the Governor’s race, Terry McAuliffe twice said he would not vote for a Budget unless Medicaid expansion was included. My HB 39 is a true compromise in that the poor would get medical care, and the taxpayers would not have to suffer through more tax increases because of Medicaid expansion.
Remember, Republican leaders imposed the last three tax hikes on Virginians, including the 2013 road tax hike. We cannot count on their “Alamo-like” resistance to Medicaid expansion unless the people make their voices heard. My HB 39 would forestall the need to expand Medicaid, and that is why it is feared.
HB 39 will not cost a dime of tax money and will avoid Medicaid fraud because Medicaid would not be used. No insurance billing bureaucracy would be needed to administer the program. Doctors would keep regular patient medical records.
Thirty years ago filing insurance paperwork cost doctors 15-30% of their revenue. Today it’s 60%+ with more to be needed for Obamacare paperwork. (Business Insider, 5/29/13). Virginia already self-insures 3,400 physicians for care they provide in free clinics with no law suits pending.
McAuliffe claims the Feds will cover 100% of Medicaid costs for three years and 90% thereafter. Recall Obama and Mark Warner’s prior failed promises: “You can keep your own insurance,” and “you can keep your own doctor.”
The U.S. Centers for Disease Control found in their 2011 National Medical Care Survey that 31% of doctors would not take new Medicaid patients. The 2012 Jackson Healthcare Physician Practice Trends Survey found that 36% of U.S. doctors will not take new Medicaid patients. A NEJM study (6/16/11) of Cook County, Illinois doctors found that “Overall, 66% of Medicaid-CHIP callers…were denied an appointment as compared with 11% of privately insured callers…” after women posing as mothers of pediatric patients with common health conditions made calls to identical clinic staff for appointments 30 days apart using the same script but identifying Medicaid or private insurance as payment.
So, a Medicaid card will not guarantee medical care for the poor.
Terry McAuliffe claims that “if we don’t accept money it will simply flow to other states.” This is not true. Virginia’s “share” of Medicaid expansion money (our federal taxes) is based on a formula. For 2016, Congress allocated $372 Billion for Medicaid for all 50 states, with $1.5 billion for Virginia. If every other state rejected expansion, Virginia would not get the entire $372 Billion.
McAuliffe has reappointed Governor McDonnell’s Secretary of Health, Dr. Bill Hazel, who has been working to expand Medicaid since passage of Obamacare in 2009. McAuliffe said, “’I am confident that Secretary Hazel will be the best steward to help me carry my agenda forward and meet the challenges we face when it comes to health care in this commonwealth.”
The Obama Administration has cut from $500 million to $1 billion in reimbursements to VCU and UVA for hospital care for indigents. The news of the VCU/UVA funding shortfall came from Health Secretary Hazel on the same day Terry McAuliffe announced he wanted Hazel to stay on as Health Secretary. Terry McAuliffe would not be seeking to re-appoint Sec. Hazel if he were not also fighting for Medicaid expansion!
Medicaid expansion may not significantly improve health. In 2008, Oregon expanded Medicaid for low-income adults. Two years later, The New England Journal of Medicine (NEJM) reported (5/2/13) “…Medicaid coverage generated no significant improvements in measured physical health outcomes in the first 2 years, but it did increase use of health care services…” Those words come from the authors of the article, not me.
Science magazine [1/2/14] further analyzed Medicaid usage of patients enrolled in the 2008 Oregon Medicaid expansion. The author’s summary reported on 25,000 Medicaid lottery participants over an 18 month period. “We find that Medicaid coverage significantly increases overall emergency use by 0.41 visits per person, or 40 percent relative to an average of 1.02 visits per person in the control group. We find increases in emergency-department visits across a broad range of types of visits, conditions, and subgroups, including increases in visits for conditions that may be most readily treatable in primary care settings. … A back-of-the-envelope calculation, using $435 as the average cost of an emergency room visit suggests that Medicaid increases annual spending in the emergency department by about $120 per covered individual.”
In other words, because it is harder and harder for patients to receive primary medical care in private doctor’s offices, Medicaid eligible patients are going to hospital ER’s for primary care at a rate 40% higher than non-Medicaid patients.
Because doctors fear lawsuits, many doctors practice “defensive” medicine which consists of ordering medical tests and treatments which shield a doctor from liability, but which may offer little or no benefit to the patient. This drives up general health care costs as well as tax-funded Medicaid and Medicare programs.
An AMA published survey, answered by 65% of 824 Pennsylvania doctors (emergency medicine, general surgery, orthopedic surgery, neurosurgery, obstetrics/gynecology, and radiology) found: “… 93% reported practicing defensive medicine. … such as ordering tests, performing diagnostic procedures, and referring patients for consultation, was very common (92%). Among practitioners of defensive medicine who detailed their most recent defensive act, 43% reported using imaging technology in clinically unnecessary circumstances. … Defensive practice correlated strongly with … perceived burden of insurance premiums.” JAMA. 2005 Jun 1;293(21):2609-17.
As more and more Doctors consider leaving the medical profession over Obamacare requirements, HB 39 can remove the burden of insurance claims for care provided by charity doctors, a significant factor increasing health care costs across the board. Relieved of that burden, doctors will be able to exercise their best clinical judgment, and not order tests to avoid litigation. Doctors under HB 39 will have no incentive to encourage behavior that produces repeat pathologies, where voluntary behavior and not genetic history, social condition or accidents, is the major causative factor in illness or subpar health.
Doctors serving the poor through charity care will not waste time with Medicaid. Physicians who treat the poor without charge will have their reputations enhanced, and attract more paying patients. Non-profit groups or churches will be better able to direct only the truly needy to their affiliated clinic doctors resulting in true patient-centered care by physicians delivered in the local community.
The drawback for some politicians may be the absence of political payback votes. In other words, instead of converting citizens into government dependents, the indigent will remain free men and women not beholden to anyone or expected to vote for a particular political benefactor.
HB 39 has the potential to take us back to a medical care delivery model that preceded Lyndon Johnson’s so-called Great Society which bureaucratized Charity by creating government programs and agencies with employees who relied upon the indigent remaining so in order to keep their jobs.
Thank you for your support!
P.S. Without your urgent calls, emails and contacts to the above committee members, we will certianly not be able to cut costs and serve those who are most vulnerable among us.
RICHMOND, VA (WWBT) -
Your phone isn’t just a phone anymore, it’s also a tracking device. Police are dialing up the cell phone companies more and more, often asking for specific information – like a user’s whereabouts or even a call log. Under current law, they do not need a search warrant.
The top cell phone companies revealed they’d responded to 1.3 million law enforcement demands for subscribers information. The On Your Side Investigators uncovered how Richmond, Chesterfield and Henrico County all use the tactic.
Republican delegate Bob Marshall says it’s got to stop.
“Just keep stepping around this, like some people want to do too often, is to jeopardize your life and your liberty,” said Marshall during a phone interview.
Marshall has introduced a bill that would require cell phones to be considered tracking devices. Police would need a warrant from a judge before phone companies hand over location data.
I have introduced three bills to address the growing disaster of Obamacare, as regards Medicaid expansion, Obamacare insurance salesmen sign-up organizers called Navigators, and keeping your previous insurance plan. This alert discusses HB 39, to provide healthcare to the indigent without expanding Medicaid.
Medicaid Expansion Will Be Pushed in Virginia
Democrat Governor-elect Terry McAuliffe wants to add 425,000 recipients to the already 1,000,000 recipients on Medicaid arguing that 30,000 jobs will be added to Virginia’s economy. Medicine should be about improving health.
Some businessmen and “moderate” Republican State Senators want to expand Medicaid because they want the promised 100% of federal funding (first three years) and jobs (political patronage?). Federal funding is not free money. It comes from “We the Taxpayers” whose tax burden continues to escalate. They also believe Virginia can exit out of Medicaid expansion if the feds do not pay the 100%. They fail to cite any legal authority in the Obamacare law or published regulations for support to back out after expansion.< During the Governor’s race, Terry McAuliffe twice said he would not vote for a Budget unless Medicaid expansion was included. It is unclear if the Republican Speaker of the House would risk what will be painted in the media as “stingy Republicans” shutting down Virginia’s government over Medicaid expansion, despite such a shutdown being Democrat Governor McAuliffe’s decision. Read more
I have been proud to serve the citizens of the 13th district for the last 22 years and I am so thankful for your support for another term! This was a very tight race and I appreciate so much the hard work of my family, friends and all of my volunteers and supporters.
Over the next two years I will continue to fight for my constituents to improve transportation, keep taxes low, protect our Constitutional rights and family values and stop Federal intrusions into our state government.
Friends, I will be having Get-Out-the-Vote events this Saturday, November 2nd at 11:00 in Manassas and at 2:30 in Haymarket. Liberals are dumping massive amounts of money into my opponent’s campaign so I need all the help I can get. If you can attend either of these events please RSVP to Claire@delegatebob.com. Thank you for your support!
Manassas Lit Drop
Time: 11:00 AM
Date: Saturday, November 2
Meet Location: Tony’s New York Pizza, 11674 Sudley Manor Dr., Manassas, VA 20109
We will meet back at Tony’s at 1:30 for pizza on me.
Haymarket GOTV Door-Knock
Time: 2:30 PM
Date: Saturday, November 2
Meet Location: Haymarket McDonald’s 6740 Leaberry Way, Haymarket, Virginia (corner of 15 & Washington St.
We will meet at the Penn Station Subs, 6424 Trading Square, Haymarket, VA 20169 (Walmart Shopping Center) at 4:30 for subs on me!
RSVP to Claire@delegatebob.com
“A wise and frugal government, which shall leave men free to regulate their own pursuits of industry and improvement, and shall not take from the mouth of labor the bread it has earned - this is the sum of good government.” -Thomas Jefferson