As deliberations about Fairfax County’s FY15 proposed budget continue, the failure of the Virginia General Assembly to adopt a state budget becomes more critical for local programs. Revenue from the Commonwealth accounts for only 2.6 percent of the county’s annual budget, but the amount, more than $95 million, equates to almost five cents on the real property tax rate. (Each penny on the tax rate generates $21.86 million in revenue.) The lion’s share ($38 million) of revenue from the Commonwealth supports public assistance for our neediest residents. This does not include $376 million in state revenue that is transferred directly to the school system, also imperiled without an adopted state budget.

That neediest population also finds itself the political football in the Medicaid impasse at the General Assembly. This week’s Special Session in Richmond was called by Governor McAuliffe to force the General Assembly to pass a budget. Medicaid expansion would qualify an estimated 400,000 Virginians – men, women, and especially children – for basic health care coverage, returning $26 billion in federal taxes, already paid by Virginians, to Virginia’s health care economy. Without Medicaid expansion, many of our neighbors will continue to seek unreimbursed health care at hospital emergency rooms. At INOVA Health Systems alone, charity care and Medicaid unreimbursed costs amounted to $174 million in 2011, and the amount grows each year. Those are expenses we all pay for, through our own health insurance and various taxes. If Medicaid expansion fails in Virginia, other states will receive our estimated $5 million per day share, which would be a travesty in many, many ways.

Senator Tim Kaine related recently his experience volunteering with a Remote Medical Area (RAM) Clinic in southwest Virginia. Once a year, medical personnel and others volunteer several days of their time in rural Virginia to provide free medical, dental, and vision care. Thousands of people line up during that summer week to get a physical, or have a tooth pulled, or new eyeglasses, so they can continue to go to work, raise their children, and eke out a living. Senator Kaine said that two-thirds of the people served at that RAM clinic would have health insurance if Medicaid was expanded. One can only imagine his frustration with the Virginia General Assembly’s opposition to granting to needy Virginians what other states are already providing their residents – affordable and accessible health care.

Governor McAuliffe is pushing hard, and the Northern Virginia delegation is mostly supportive of Medicaid expansion. What is hard to understand is the opposition from many other General Assembly members downstate, whose constituents would be so well served by Medicaid expansion. Rural hospitals, especially, have difficulty providing uncompensated care, and face the prospect of going out of business without the additional resources that Medicaid expansion could provide.

Health care should not be a privilege in Virginia. In the home of the Bill of Rights, it should be a right, and the responsibility rests with the General Assembly members, who need to do their jobs – now! – for diverse communities, and move us forward.

 Penny Gross is the Mason District Supervisor, in the Fairfax County Board of Supervisors. She may be emailed at mason@fairfaxcounty.gov.