By Charlotte Rene Woods

While Abigail Spanberger’s former congressional colleagues stayed up late Tuesday night debating proposed cuts to Medicaid in a jumbo GOP bill to reduce federal spending, the Democratic gubernatorial nominee outlined her health care-focused plans if she becomes Virginia’s next governor Wednesday morning at a local independent pharmacy in Mechanicsville.

Standing in Mechanicsville Drug Store, a family-owned business that’s nearly 70 years old, Spanberger drove home her legislative priorities to lower prescription drug costs and close rural health care gaps in the state. 

“It’s essential that we be able to strengthen access to health care, improve affordability, and recognize that for so many Virginians, they’re one medical event away from really substantial ruin,” Spanberger said. “But for so many, (health care cost) is just one more worry that keeps them up at night.”

Speaking near the counter where prescriptions are filled in the back of the store, Spanberger said threats to health care coverage spurred her to run for Congress in 2018. During President Donald Trump’s first term in 2017,  members of Congress tried to repeal the Affordable Care Act. That federal legislation made it possible for states like Virginia to expand their Medicaid program to encompass more people who fall through health coverage gaps. 

With a similar sense of medical coverage uncertainty now pervading the nation’s capital, Spanberger said she wants to protect access to care here at home.

“As we see challenges coming out of Capitol Hill in Washington, DC, as governor, I will focus on what can be done here in Virginia,” Spanberger said. 

She also plans to create a statewide hospital price transparency comparison tool to help people better weigh their options for treatments and drugs, uphold consumer protection laws and direct the next attorney general to identify and crack down on scams that may fraudulently enroll people in unnecessary coverage, Spanberger said. 

Virginia’s “safety net” providers, like free clinics and community health centers, can also count on Spanberger’s support if she ascends to the governorship, she said. Virignia’s free clinics have for years requested more funding from the state legislature to stay afloat and serve the  most vulnerable populations, especially under- or uninsured people and rural patients who live further from hospitals. She also laid out her intention to work with Virginia’s hub of medical manufacturing companies to increase the production of generic drugs that more people would be able to afford. 

One thing Spanberger’s plans didn’t include is a Prescription Drug Affordability Board.  A bipartisan proposal to create an independent board of medical and health experts tasked with analyzing data to set payment limits on drug prices within state-sponsored health plans has failed multiple years in a row in Virginia’s legislature. After clearing the legislature this year, the measure was vetoed by Gov. Glenn Youngkin in late March. 

While PDABs have gained traction in several states in recent years, they have not been without skepticism — particularly as other states’ boards, like Maryland’s, have taken years to set up and have not yet fully yielded the savings they’ve promised. 

Spanberger is also cautious and said Wednesday she would keep an eye on the proposal but stopped short of endorsing it. 

“I want to make sure that whatever we might implement in the future will be a best practice based on the successes or challenges that other states have faced,” she said. 

A new law that will take effect next year also aims to boost drug affordability, and has Spanberger’s stamp of approval. 

A bipartisan coalition of lawmakers introduced the “Save Local Pharmacies Act” this year, which outgoing Gov. Glenn Youngkin approved. 

Once implemented, the law will eliminate health-run-plan pharmacy benefit managers in Medicaid and establish a single state-contracted one — a move supporters say would improve accountability, lower costs and help independent pharmacies stay afloat. The proposal drew support from both independent pharmacy owners and workers in chain pharmacies during the 2025 legislative session.

Sen. Aaron Rouse, D-Virginia Beach, who is among several Democratic candidates that will face off in a primary next month for the lieutenant governor nomination, said that he is “proud that (Spanberger) agrees this is the type of strong action we need to help Virginians.”

Rouse had been the chief patron of the PBM reform bill and worked closely with colleagues to pass it. 

A spokesperson for Lt. Gov. Winsome Earle-Sears, who is the Republican nominee for governor, did not immediately return calls Wednesday when asked for more details about Earle-Sears’ health care policy stances and thoughts on federal Medicaid debates. 

Her campaign website does not spell out concrete health care plans, but more broadly points to a goal of reducing the cost of living. 

“She will scour the government books to cut wasteful government spending and job-killing regulations because taxpayers know how to spend their money and run their businesses better than government,” Earle-Sears’ website reads. 

Hanover County resident Ann, who declined to share her last name and identified herself as a Republican voter, was skeptical of what Spanberger had to say during her pharmacy visit on Wednesday. 

Ann said she doesn’t know enough about the pharmacy benefit manager proposal Spanberger is backing but another health care issue is a priority for her going into this year’s state elections: abortion. 

While she isn’t sure what week of pregnancy she would like to see abortion restricted, she thinks current law and the in-progress constitutional amendment to enshrine broader reproductive rights goes too far. 

“I don’t want it to be completely banned, but there do have to be restrictions,” she said. “When you abort and murder a live baby, that is something very sinister.”

Current abortion law allows the procedure for any reason until about 26 weeks, with exceptions for the rare instance where people have later abortions — typically related to medical emergencies. Virginia Republicans and President Trump have for years incorrectly stated that Virginia Democrats support infanticide, which is illegal.

Spanberger has voiced her support for abortion access repeatedly, tweeting on the second anniversary of the Supreme Court’s dismantling of federal abortion protections that “Virginians are worried about the future of abortion access — but they are also deeply worried about extreme politicians attacking IVF and contraception. As Virginia’s next Governor, I will defend our fundamental rights.”

Earle-Sears has decried abortion, speaking against the procedure as a keynote speaker at this year’s March for Life rally and literally marking her disapproval of an in-progress constitutional amendment protecting reproductive health care access, including abortion. In her duty as lieutenant governor, Earle-Sears has to sign passed legislation, and as the reproductive rights measure cleared the legislature this year, she signed it with a note that she was “morally opposed” because she didn’t feel it protected “the child.”

Republicans had sought to insert an amendment into the measure that would further outline existing state and federal law concerning live births. Democrats, who control the House and Senate currently, rejected the idea because it’s already on the books. The proposed constitutional amendment must pass the legislature again next year before appearing on statewide ballots. 

Ann, the Hanover Republican, knows that partisan control of the House of Delegates and the political position of the incoming governor will be pivotal in shaping the future of Virginia’s abortion laws.  It’s why she has her eye on “all of them.”