Kaine sits down with town, county leaders

During recess from Congress, Sen. Tim Kaine, D-Virginia, likes to tour communities and hear his constituents' concerns.

On Wednesday, the first-term senator and former govenor visited Culpeper and sat down with a conglomerate of Culpeper's leaders — Mayor Chip Coleman, Culpeper County Administrator Frank Bossio, Culpeper County Board of Supervisor Chairperson Sue Hansoh, Culpeper Regional Hospital CEO Lee Kirk and others — to discuss issues that not only affect the nation but ones that impact the county.

Kaine started by explaining that he serves on three committees in senate, on three issues close to his heart. A member of the budget, armed services and foreign relations committee, Kaine explained the problem the senate faces with financial situations.

"When I was sworn into the senate, the senate hadn't done a budget in four years for a variety of reasons," Kaine said. "We've done a budget, it's a good budget. It replaces sequester with a much smarter approach. It's been frustrating because the house will not commence a budget conference with us. They think the budgets are too far apart."

Kaine mentioned some economic fundamentals are coming back faster than other economies, including homes.

He then opened up the discussion for questions, asking town and county leaders about issues they face.

"On the county side, I don't think we have as many issues with the federal as we do with the state," Hansohn said.

Bossio brought up the issues with the Affordable Health Care Act, and how the county is having to guess what to do since there are no concrete answers at the moment.

"Now we're sort of in a pause, but we're in the middle of what to do with employees vis-a-vie part time versus full time," Bossio said. "We're making decisions that will affect people's lives based on what we think versus what we know will happen."

Bossio asked what the cost of the ACA is going to be and what the upside and downsides are.

"There's a lot of conversation about that in Congress, though I'm trying to encourage colleagues to have discussions about reforms and fixes instead of trying to find the 45th vote to repeal," Kaine said. "That's not going to go anywhere. We've had a couple of reform votes already. There's a whole lot in the healthcare space where we ought to be solving problems."

Hansohn pointed out that the ACA seems to make it harder for middle class families to be able to afford insurance.

"We have employees in social services and even teachers that they're insurance costs are so high," Hansohn said. "They went up again this year."

Kaine responded that the state exchanges have created a competitive mechanism, but that Virginia is late to the party in that regard.

"Virginia was a laggard in embracing the exchanges," Kaine said. "The idea was we didn't do anything with an exchange until we waited to see what happened with the Supreme Court decision. Some of the states that went and did the exchange right out of the gate have seen some positive affects on the cost and the availability."

With the topic centered on health care, Kirk chimed in saying that 25 percent of Culpeper Regional Hospital's emergency room patients are self pay. The hospital as a whole sees 10 percent of the population as self pay.

"We're never going to bend the cost of health care until those individuals have reasonable access to health insurance and primary care physicians and don't seek primary care in an emergency room setting," Kirk said.

Kaine asked what percentage of the 25 percent in the ER would be covered by a Medicaid expansion. Kirk said the estimate is 60 percent.

The other issue Kirk said the industry is facing is a shortage of primary care physicians, and in Culpeper they've employed a lot of nurse practitioners to deal with it.

The final questions in the 40-minute sit down chat centered on military and foreign policy. Bossio, an Air Force veteran, was extremely concerned with the situation Veteran's Affairs is facing.

"As we talk of the sequestration and we talk about issues with the VA," Bossio said. "The VA things are getting seemingly better but the numbers and issues they're dealing with are getting worse. We have to find a way to get to those solutions quickly."

"The VA backlog is a very serious one," Kaine said. "It's one of the many reasons I think this sequester stuff is so serious. There wasn't really an effort to build a centralized electronic record keeping system until 2009."

The other question that Kaine faced was on foreign policy, with the situation in Syria deteriorating.

"What's happening in Syria?" Hansohn asked.

Kaine, the chairman of the Committee on the Near East, which overseas the Middle East, said he's very concerned with the implications of the chemical attacks in the country.

"I'm very much a stickler on that, I don't think the President should take military action without the approval of Congress," Kaine said. "Notice I didn't say before the approval of Congress, I said without the approval of Congress. The challenge we face in Syria is there has been an international norm for the use of chemical weapons. If you allow that norm to be broken, that's a very serious thing. There needs to be a response for that."

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