Gov. Terry McAuliffe, a Democrat, has tried for four years to expand Medicaid coverage under the Affordable Care Act, but each time he has run into a Republican firewall in the House, in which O’Bannon has been a pillar as a ranking member of the House Appropriations Committee and its subcommittee on health and human resources.

“We’ve taken a deliberative approach on Medicaid,” he said in an interview last week. “We’re comfortable with where we are.”

But O’Bannon said that doesn’t mean he and House Republicans have stood pat on health care. He points to the House’s support of a McAuliffe proposal to use Medicaid to provide services to people with mental illness, as well as a new waiver program for addiction and recovery services treatment, or ARTS.

“Regardless of who wins in November, we’re going to have to continue to work on Medicaid and our safety net and our vulnerable populations,” he said.

Rodman said those initiatives, while laudable, are “like putting a Band-Aid on a bullet hole,” while the state is forgoing billions of dollars in federal funding that could free state money for other needs.