With the difference between Democrats and Republicans in the Richmond House of Delegates now narrowed to what a single vote can do, the matter of Virginia providing health coverage to an additional 400,000 of its citizens is now on the table. When the legislature was 66-34 pro-Republican, there was no way the state would agree to receive up to $5 million a day (a day!) from the federal government to subsidize the expansion of its Medicaid program, because the plan was set up under the auspices of the hated (by Republicans) Affordable Care Act, or Obamacare.

Now, with the political margin hair thin, and another round of a Democratic sweep for its statewide offices has occurred, we’re hearing a different tune. As State Sen. Richard Saslaw told the town hall meeting in the Falls Church Community Center last weekend, if the Medicaid expansion comes, it will probably be under some different label. Well, frankly, who cares? New Democratic Gov. Ralph Northam, a physician himself, got in hot water with some in his own party recently when he used alternative language about the matter in an effort to win still-necessary (but not universal) GOP support, and he had to make clear that he remains committed to the expansion of Medicaid under the Affordable Care Act.

So, Sen. Saslaw’s comment appears to be the way it’s going. Now, six important Chambers of Commerce in Virginia, including the monolithic Northern Virginia (formerly Fairfax County) Chamber, have issued statements assembled by the Virginia Hospital and Health Care Association (VHHA) showing they all “support coverage of the uninsured and the positive economic benefits it provides,” according to a VHHA press release issued yesterday. The Chambers are the Bristol, Richmond Region, Hampton Roads, Charlottesville and Roanoke ones, in addition to the Northern Virginia’s. Together they represent more than 6,000 businesses with nearly 1.2 million employees in Virginia. (The Greater Falls Church Chamber was not involved).

“Many Virginia Chambers support this because it will return taxpayer dollars to the Commonwealth, have a positive effect on public health, help workers, stimulate new employment and boost the economy,” the VHHA statement says, citing an economic analysis projecting total economic impact from increased coverage averaging $3.5 billion and 26,500 jobs over five years, nine times greater than if nothing was done.

On top of that, newly-inaugurated Gov. Northam, speaking at a Virginia Interfaith Center public policy conference yesterday, said it is time to move ahead with the Medicaid expansion to serve the 400,000 individuals in most cases “working one, two and three jobs and who can’t afford coverage.” He added, “No individual, no family, should be one medical illness away from financial demise. Nobody in this country, in Virginia, should have to make a decision as to whether they stay home or go and seek medical care.”

Some remain concerned by efforts to link coverage to employment, which they say will only deter applications.