By Kathy Cole

The fact that our Virginia legislators will not accept Medicaid expansion on any terms is disastrous for the 400,000 Virginians left without health care coverage, many of whom live in the 9th Congressional District.

The Affordable Care Act (Obamacare), based on a conservative plan from the 1990s, is imperfect to be sure, but it attempts to cover as many people as possible with a mix of private-sector and government programs: Subsidized private plans, more leeway for children to stay on their parents’ plans, employer mandates, coverage requirements, etc.

The extension of Medicaid to low-wage workers is a key piece of this “quilt” of programs. These citizens make too much to qualify for regular Medicaid, but too little to purchase private insurance.

In the original legislation, this would have been put in place in each state along with the other parts of Obamacare.

When the ACA was challenged (and upheld) in the Supreme Court, the judges ruled each state could decide whether to implement the Medicaid expansion. This should have been a no-brainer; it is a key part of this health care plan that has been ruled constitutional and legal.

However, in 19 states (including our own), this program is being refused, despite the fact that the cost is covered completely for two years and then 90 percent thereafter — with our federal tax dollars. Our refusal to bring our tax dollars home to help our own citizens means that they will go to another, more enlightened state.

More conservative states than our own — Ohio, Alabama, Pennsylvania — have accepted the expansion after negotiating terms they can live with.

Just who are the losers in this stand-off? It is the working poor, citizens who work hard and play by the rules, trying to get ahead, trying to succeed, trying to feed and house and educate their families.

Many are making minimum wage; many want full-time work but are cobbling together two or three part-time jobs.

These are the people we are denying health care coverage. These are the people who do not seek care when needed and then require expensive emergency care. These are the people making it difficult for hospitals to balance their budgets. And all because of a knee-jerk reaction by our legislators that “if it is part of Obamacare, we must refuse it!”

Their fear is facing a challenger from the right if they dare to break ranks on this issue. It is a sad fact that legislators care more about keeping their jobs than fulfilling the oath they take to serve the people who elected them.

I have talked with Del. Israel O’Quinn, a sincere young public servant who has volunteered at the free RAM clinic in the 9th District and therefore knows the dire conditions this program could alleviate.

He can only insist that the state “cannot afford” Medicaid expansion. That tells me he does not dare cross his GOP colleagues, and I am sorry that he will not stand up to them on behalf of this great need in his district.

The dire consequences predicted by those opposed to the ACA have not come true. Insurance companies have many new customers and are doing just fine; the rate of health care inflation has slowed; hospitals are reimbursed for care of insured patients rather than providing expensive emergency care, often for free.

Young adults have a bridge through their parents’ policy while they get established in the workforce. Previously “uninsurable” adults with pre-existing conditions can now purchase policies.

It is time to get beyond the rhetoric and accept Obamacare, including Medicaid expansion.

Ideologically, it is a conservative health care plan, not a liberal bogeyman. The continued resistance of our GOP legislators looks like nothing more than a partisan standoff that is hurting people who work hard and deserve to have what people in other states have — basic health care coverage.