People who could benefit from an expansion of Medicaid that closes the coverage gap by insuring more of the working poor are found throughout the Commonwealth. The highest percentages of such persons tend to be in the southside and southwest regions of the state. Impose a map of regions represented by Republicans and Democrats over a map reflecting the highest percentages of the working poor and the two maps are close to identical. Yet, Republicans who represent areas of great need oppose the expansion of Medicaid, and Democrats who have large numbers of persons but a smaller percentage of those who would benefit from the expansion support it. The historic interest of the two parties explains in part this contradiction, but there are other explanations as well.

Just as the Koch brothers are known for their influence in other states, they are hard at work as well in Virginia. Defeating "Obamacare" as they refer to the Affordable Care Act with a smirk and disgust is one of their major goals. According to the Virginia Public Access Project (www.vpap.org), Americans for Prosperity that is their organization has 14 individuals who are listed as "registered lobbyists." Their expenditures for 2013 in the radio and TV markets of Hampton Roads and Richmond with lesser amounts in Washington and Roanoke total $967,731. In 2012 they spent $3,702,232 trying to defeat President Obama in Virginia. They are not required to disclose their donors.

One recent radio ad by Americans for Prosperity asked listeners to call their delegates to "thank them for putting Virginia's future ahead of Obama's agenda." Another ad that ran earlier this year was more emphatic! "Medicaid expansion is Obamacare, and it's threatening the quality of health care for millions of Americans...In Virginia you could lose your health care, or your doctor."(Americans for Prosperity VA) As downstate voters are inundated with this advertising and the repeated distortions of Fox News, it is little wonder that they might at the least be confused and when mixed with the unpopularity of the President in these regions, it is not surprising that many of them would be opposed to the expansion of Medicaid.

Unfortunately the legislative leaders of these areas who should be able to separate more factual information from the Koch-inspired hate campaign against anything associated with President Obama are not willing at this point to stand up for their constituents who could most use the health care. As Richmond columnist Jeff Shapiro wrote last week, Republican legislators who are generally in gerrymandered safe districts "focus on making themselves even safer in generally safe districts" by working to preclude "a nomination challenge from the right--they stand firm for gun and property rights and against taxes, abortion and, these days, anything that passes for Obamacare." (Richmond Times-Dispatch, April 2, 2014)

Voters and legislators in Virginia find themselves under the influence of the endless media campaign funded by the out-of-state Koch brothers. When will someone be willing to stand up for Virginians? When will legislators who represent thousands of Virginians who need an expansion of health care be willing to stand up for their constituents?