06/17/2014 04:10 pm ET Updated Aug 17, 2014

A Profile in Cowardice

Public servants of all backgrounds and political affiliations are familiar with John F. Kennedy's text, Profiles in Courage, which documents moments of moral courage demonstrated by elected officials in the face of adversity. Now, here in southwest Virginia, we must settle for a Profile in Cowardice.

The story began early last week when Senator Philip Puckett, a Democrat representing a district in Southwestern Virginia, resigned from the Virginia General Assembly.

The Washington Post reported that Puckett's departure came after Republicans offered him a top position on the state tobacco commission for himself (Puckett later withdrew). To us, this was not an act of political maneuvering. This was cowardice, coming amidst arguably the most important and critical debate in Virginia's recent history.

Virginia's General Assembly has been in a stand-off with Governor Terry McAuliffe on the question of whether Virginia should expand Medicaid in Virginia. Expansion of Medicaid would extend basic, life-affirming health coverage to the nearly 400,000 of the most vulnerable Virginians. The balance of power on the decision lay in the Virginia Senate, where Democrats and Republicans each held exactly 20 seats.

All that changed after Puckett's resignation.

Less than a week after he stepped down, the General Assembly adopted a budget without Medicaid expansion, striking a major blow to the movement to extend coverage to those who need it most.

Just like that.

As constituents of Senator Puckett, we can't help but find his actions unsettling. An act not of courage, but of cowardice. Many of the poorest and sickest Virginians live in our (his) backyard. More than 20,000 in Senator Puckett's district alone would have benefited from Medicaid expansion; and that, too, at no cost to the state.

The storyline here is clear. And tragic. Senator Puckett placed the interest of himself and his family above that of his constituents. jeopardizing the lives and health of thousands of vulnerable Virginians.

As youth in Virginia, we fell in love with civics after participating in Virginia's Model General Assembly (MGA). We served as the Speaker of the House Pro Tempore and Youth Governor . We were inspired by the tradition of Washington and Jefferson -- Virginians who served with integrity and honor. These were Profiles in Courage -- public servants that all Virginians (and Americans) could be proud of.

Now, we wonder: must we settle for Cowardice?

As a physician and aspiring physician from southwest Virginia, we affirm that we can and must do better for vulnerable Virginians.

And we will.

Senator Puckett's defection has all but doomed Medicaid expansion in Virginia.

The Senator may not be willing to stand up for health of southwest Virginia, and our state. Thankfully, many of our public servants are. We stand with our leaders -- including our Governor -- who dare to dream of health for all Virginians. We, the people of Virginia, must bring courage back to our General Assembly. After all, we are Virginians, not cowards.