Finally, Even Republicans in Virginia Embrace Health Care for Low Income People

The Cruelty of Conservatives May Stop

Virginia is one of the Republican controlled states that refused to expand Medicaid. To even get Medicaid in the state residents had to be not just poor, but as poor as some of the weakest economies in the world.

Currently, Virginia has one of the most restrictive Medicaid programs. Childless adults are not eligible and working parents cannot exceed an income of 30 percent of the federal poverty level, or $5,727.

But reality, read elections, are changing things.

Elections have consequences, goes the old saw, and in Virginia a Democratic wave in November remade the political landscape on one of the state’s longest-running and most contentious issues: whether to expand Medicaid to 400,000 low-income residents.

Republicans lost 15 seats in the House of Delegates and, left clinging to a bare majority, did an about-face on Medicaid expansion — an issue that to many had smacked of “Obamacare.” But Republicans in the State Senate, who had not faced voters, blocked expansion last month, and lawmakers failed to pass a state budget because of the issue.

Now, as Gov. Ralph Northam orders the House and Senate back to the capital on Wednesday for a special session to fix the problems, what remains of Republican opposition to expansion appears to be cracking.

Two Republican state senators said this week they would accept some form of broader Medicaid benefits, as provided under the Affordable Care Act — enough votes to carry the day on an issue that is widely popular in state polls.

And the Republicans who are changing are learning first hand how vicious conservatives can be.

Mr. Kilgore’s district in southwest Virginia is one of the poorest in the state, where each July thousands of people visit a free pop-up clinic at a county fairground.

Delegate Chris Peace, another Republican who favored expansion in the House, said he had changed his position in part because in his family law practice, he had come to see the dire effects that a lack of health care had on low-income families.

He called the House bill that includes work requirements “the epitome of the Republican conservative mantra of a hand up, not a handout.”

Ahead of the special session, activists from the conservative group Americans for Prosperity have demonstrated outside Mr. Peace’s office in Mechanicsville, trying to pressure him to change his mind.

He dismissed them as remnants of the Tea Party movement straining to remain relevant. “Half are 60-plus gray-haired white men who hate Obama,” he said.