A group of recalcitrant Republicans in the Virginia House of Delegates have blocked Medicaid expansion at every opportunity. They are so determined to keep poor people from getting health care that they are preventing passage of a two-year budget for the state for the fiscal year beginning July 1. If an agreement isn’t reached by then, they seem fully prepared to let the state government shut down, furloughing employees and shuttering services just as their counterparts in Washington did last fall.