Speak Out: Should Virginia Opt Out of Medicaid Expansion?

As Gov. Bob McDonnell considers opting out of the , Virginia lawmakers are divided on whether the program would help or hurt the state.

In a letter to McDonnell on Thursday, Lt. Gov. Bill Bolling, a Republican who has announced a 2013 gubernatorial bid, encouraged the governor to reject the program, saying Medicaid expansion — which he says accounts for nearly 20 percent of Virginia's total general fund spending — would place "tremendous fiscal pressure on the Commonwealth and divert funds from other state programs, such as public education, higher education, public safety, natural resource protection and even other critically important health care programs."

McDonnell sent a letter to Virginia lawmakers Tuesday expressing his concerns with the program, saying opting into a Medicaid expansion — which would require the state to create exchanges through which residents could buy health insurance — without more policy information was irresponsible, according to the Washington Post.

The Republican governor said the program, and costs associated with it, could ultimately be unnecessary if a new Congress and president elected in November are able to repeal the act in 2013, the Post reported.

In his own letter to the governor and other leaders, U.S. Rep. Gerry Connolly, (D-11th District) said opting out of the program was a "costly mistake," one that would cause Virginia to lose out on the $9.2 billion in federal funds he says the state would receive in first five years of the program.

Connolly said federal funds would cover the first three years of the program, which would help about a quarter million uninsured Virginia residents.

"The choice we face as Virginia’s leaders is momentous. Will we move forward together to implement these historic reforms, reversing our unsustainable trajectory of spiraling costs? Or will we allow this once-in-a-lifetime opportunity to leverage billions of dollars of federal funds to help Virginia’s families, businesses, and bottom line?" Connolly wrote. "I urge you to seize this opportunity to make life better for all Virginians."

For every dollar Virginia spends on the program, it would receive $17 in federal money, the Post reported.

Bolling said increasing Medicaid enrollment, which he predicted would double by 2022, would cost $2.1 billion from the state general fund and another $31.3 billion in taxpayer money in that time.

Connolly cited figures from Virginia Health Reform Initiative Advisory Council, a committee McDonnell formed to help plan the implementation of the Affordable Care Act, that showed "ACA reforms, including the Medicaid expansion, would reduce uncompensated care costs borne by Virginia’s government, families, businesses, and hospitals by $860 million."

For the full Washington Post story, click here.

Tell us: Would participating in the expansion help or hurt the state? Leave your thoughts in the comments.

To see Connolly speaking on the Supreme Court's June health care decision, and McDonnell speaking on his recent letter, watch the videos in the media player above.