Virginia’s Ugly Fight Over Medicaid Expansion

It just got uglier.

Virginia Sen. Phillip Puckett.
Democratic Sen. Phillip Puckett is resigning from the Virginia Legislature.

Courtesy of Phillip Puckett for Senate

When it comes to heaping new kinds of crazy on top of all the old kinds of crazy, there is simply nothing like the Commonwealth of Virginia. 

Yesterday the Washington Post reported that Democratic Virginia state Sen. Phillip P. Puckett would resign, allegedly to accept a lucrative new job as deputy director of the state tobacco commission, and to pave the way for his daughter to get a permanent judgeship. Puckett’s move flips control of the state Senate over to Republicans, who have been locked in a fight to the death with Gov. Terry McAuliffe over his push to expand Medicaid in the commonwealth. He tendered his formal resignation this morning, to much public outrage over a possible quid pro quo. This afternoon he indicated that he will not be seeking the tobacco commission job after all. (His daughter, as far as I know, will still get her judgeship.) 

Until we know more about the deal itself, it’s difficult to say much about the legal questions beyond the fact that it stinks pretty badly. Commentators are already using the word bribery, and also bribery, to describe the nature of the arrangement. Here’s what we do know: The partisan fight over Medicaid expansion—which would have afforded 400,000 more Virginians access to affordable health care—has turned into a statewide snarling contest over the new state budget, one that may end in a government shutdown if it’s not resolved before the start of the commonwealth’s new fiscal year on July 1. The Virginia House is controlled by Republicans, who are fighting the Medicaid expansion tooth and nail. Until today the Senate was split 20–20 along party lines with a tie-breaking vote going to the Democratic Lt. Gov. Ralph Northam. Not only does Puckett’s departure mean that Democrats lose control of the Senate and possibly the Medicaid fight, he also represents a heavily Republican region that will likely become a permanent GOP seat after the special election to replace him. It has also not gone unobserved that this same heavily Republican region would benefit significantly from the proposed expansion. An estimated 20,000 of Puckett’s constituents would be eligible for health coverage under the expansion.  

Virginia is one of 24 states that has refused to accept the Medicaid expansion—federal money that would pay for health care coverage for Americans who make too much to qualify for current Medicaid benefits and too little to afford Obamacare. McAuliffe campaigned on a promise to take it, and he has insisted that an expansion must be part of the new budget. Republicans want him to decouple the expansion from the proposed two-year budget. As a result, each side is trading accusations that the other will shut down the government over Medicaid. If both the Senate and the House vote against the expansion, McAuliffe will be forced to veto the budget, at which point the optics will suggest that he’s the source of the shutdown. He has also apparently been exploring mechanisms by which he could bypass the Legislature altogether and pass the expansion by executive order. Either way, it won’t be pretty for him.

Before Puckett resigned, McAuliffe could have continued to push the expansion with the backing of the Senate. So why did Puckett decide to leave now? According to the Washington Post Puckett did not respond to calls seeking comment about the deal. But “other Republicans denied that Puckett was offered the jobs in exchange for his resignation.” Puckett cited family reasons for stepping down, and the generous reading of the Puckett deal is that he did it to advance his daughter’s judicial career. Martha Puckett Ketron is a juvenile and domestic relations district court judge with a temporary appointment that could only be made permanent if her father resigned his seat: The Senate has a policy against appointing the relatives of legislators to the bench. Del. Terry G. Kilgore (R-Scott), chairman of the tobacco commission, put it this way to the Post last night: “It should pave the way for his daughter. … She’s a good judge. … I would say that he wanted to make sure his daughter kept her judgeship. A father’s going do that.” Maybe. But 20,000 constituents without health care are probably wondering why a legislator is going to do that in order to do that

I am hardly the first person to point out that the former governor of Illinois, Rod Blagojevich, was indicted for trying to sell Barack Obama’s former Senate seat, and on charges of using his position to benefit himself, his family, and his campaign. Right now Virginia is on the edge of its seat as we prepare for the corruption and bribery trial of former Gov. Bob McDonnell and his wife Maureen, who face a 14 count indictment stemming from their acceptance of more than $165,000 in gifts and loans from Jonnie R. Williams Sr., the CEO of Star Scientific. The trial starts July 28. Key questions will include what “bribery” really is and what “quid pro quo” really means. And those are precisely the questions, according to Think Progress’ Ian Millhiser, that we should start asking about Phil Puckett as well. As he writes today, “Under Virginia’s bribery law, it is a felony for a state lawmaker to “accept[] or agree[] to accept from another … any pecuniary benefit offered, conferred or agreed to be conferred as consideration for or to obtain or influence the recipient’s decision, opinion, recommendation, vote or other exercise of discretion as a public servant or party official.” 

Early reporting suggests that with the Senate now split 20–19, it is likely to vote against expanding Medicaid, but that isn’t a certainty. Three GOP senators had hinted that they would vote for the expansion, in which case Puckett’s defection won’t necessarily tip the outcome. Still, the threat to the Medicaid expansion is real. Already this morning, Chuck Colgan, a Senate Democrat who is co-chairman of the Senate Finance Committee, suggested that maybe it’s time to pass a state budget without expanding Medicaid eligibility and revisit the expansion later, in a special session. This is essentially what state Republicans have been asking for all along. In a contest to see whether Virginia Republicans or McAuliffe would blink first, McAuliffe may have just had an eye taken out.