THANK YOU
for helping to ensure that Southwest Virginia always has a voice at the table in Richmond
CONTRIBUTE TO TODD PILLION
GETTING RESULTS FOR SOUTHWEST VIRGINIA
Conservative Leadership That Delivers
Todd didn't go to Richmond to make speeches. He went to get results. A pediatric dentist, former Army National Guard Major and Operation Iraqi Freedom veteran, and lifelong Southwest Virginian, he has spent more than a decade fighting for the values our region holds dear — faith, family, the Second Amendment, the sanctity of life, and a government that lives within its means — while bringing home the funding our communities have waited generations for.
Today Todd serves on Senate Finance & Appropriations and has been a budget negotiator three years running; the only Southwest Virginia voice in the room when the Commonwealth's budget is written. He chairs the Virginia Opioid Abatement Authority and the Southwest Virginia Higher Education Center. His record speaks for itself.
100
bills signed into law
0
vetoes — ever
$150M+
opioid settlement dollars delivered as OAA Chairman
100%
VCDL pro-gun rating, six straight years
95%
Family Foundation of Virginia score
3
straight years as a state budget negotiator
Results for Southwest Virginia
Fighting the Opioid Crisis
Far Southwest Virginia was ground zero for the opioid epidemic, and Todd refused to accept it as something our region had to live with. He has carried more than 25 opioid and addiction bills into law and, since 2021, chaired the Virginia Opioid Abatement Authority — making sure the money drug companies owe our communities actually reaches them.
$150 million+ delivered to communities. As OAA Chairman since the Authority's creation in 2021, Todd has directed more than $150 million in settlement funds to cities, counties, and state agencies — including $27 million+ to Southwest Virginia programs like Wildwood Health & Wellness (Dickenson), SECOR (Russell), Brighter Paths (Washington), and Strong Futures (Wise).
A national model. Virginia's approach was the only one in the country honored with the Johns Hopkins Bloomberg School of Public Health's Award for Excellence in applying the Opioid Litigation Principles (2023).
Overdose deaths falling faster than anywhere in America. Virginia led the nation in year-over-year reduction of overdose deaths — down nearly 40% from 2023 to 2024, and down again in 2025.
Narcan in every school. Wrote the law requiring every Virginia public school to stock naloxone and teach overdose prevention in grades 9–12 (SB 726, 2024).
Made “tranq” trafficking a felony. Signed by Governor Youngkin at Abingdon High School (SB 614, 2024).
Locked settlement dollars into treatment. Created the Commonwealth Opioid Abatement and Remediation Fund (SB 1414, 2023).
Stopped forged prescriptions. Authored Virginia's opioid e-prescribing mandate to end doctor-shopping and paper-script fraud (HB 2165, 2017).
Cracked down on diversion. Restricted Subutex, scheduled gabapentin, required prescribers to check the Prescription Monitoring Program, and put safe-prescribing training in every Virginia medical, dental, nursing, and pharmacy school (2017–2019).
Naloxone in more hands. Made it available to any Virginian, corrections officers, and first responders (SB 1415 & SB 1424, 2023).
Recovery courts that work. Created the Recovery Court Act to expand drug courts that hold offenders accountable and get them clean (SB 725, 2024).
Protected kids from abusing Nirtous. Banned the sale of nitrous oxide devices to minors (SB 1361, 2025).
Results for Southwest Virginia
Standing Up for Our Values
In a General Assembly controlled by Richmond and Northern Virginia liberals for most of his Senate career, Todd has been a steadfast conservative vote — never wavering on the Second Amendment, the right to life, secure elections, or the rule of law.
Second Amendment
100% VCDL rating, six straight years. Rated 100% pro-gun by the Virginia Citizens Defense League every year 2020–2025, and 98% in 2026.
NO on the 2020 gun-control package. Voted against every bill — universal background checks, “red flag” confiscation orders, one-handgun-a-month, and local gun bans.
NO on the assault weapons ban. Every time it came up: 2023, 2024, 2025, and 2026.
NO on the gun and ammo tax. Also voted against waiting periods, magazine bans, age-21 restrictions, and gun-industry liability schemes (2024–2026).
Armed campus security. Passed the law letting Southwest Virginia Higher Education Center officers carry firearms (SB 1368, 2025).
Protected the right to carry. Voted for concealed-carry reciprocity and to let protective-order holders carry (2016–2017).
Life
NO on abortion until birth. Voted against the Democrats' abortion constitutional amendment every time it came before the Senate (2023, 2025, 2026).
Defunded Planned Parenthood. Voted to strip its state funding as a Delegate — and to override Governor McAuliffe's veto (2016–2017).
Helped defeat the 2019 late-term abortion bill that would have allowed abortion up to the moment of birth.
Secure Elections & the Constitution
Kept photo ID. Voted to preserve Virginia's voter ID law and against every attempt to weaken it.
NO on the redistricting power grab. Voted against the Democrats' mid-decade redistricting amendment (2025–2026) — later struck down by the Supreme Court of Virginia.
NO on felon voting and the ERA. Voted against automatic voting-rights restoration and against the Equal Rights Amendment.
Cleaner voter rolls. Voted to remove deceased voters and require Social Security verification for absentee ballot applications.
Rule of Law & Immigration
NO on licenses for illegal immigrants. Voted against driver privilege cards (2020) and against repealing the law requiring jails to report illegal immigrants to ICE.
Backed sheriffs' cooperation with ICE. Voted against the 2026 bill restricting local 287(g) agreements.
No sanctuary cities. Supported the ban as a Delegate and voted to override the Governor's veto (2018).
NO on abolishing the death penalty (2021) and NO on marijuana legalization every year it has come up.
Stood with police. Voted against the 2020 “police reform” package that handcuffed law enforcement.
Working Families, Not Big Government
NO on the $15 minimum wage mandate. Every time: 2020, 2024, 2025, 2026.
NO on government-union bargaining. Voted against repealing Virginia's ban on public-sector collective bargaining and against every paid-leave mandate on small business.
NO on the Clean Economy Act and RGGI. Voted against the carbon tax that raised electric bills (2020).
Results for Southwest Virginia
Bringing Our Tax Dollars Home
For decades Southwest Virginia sent its tax dollars to Richmond and watched them get spent somewhere else. As a budget negotiator on Senate Finance & Appropriations, Todd has changed that — securing historic investments in the roads, sites, and projects that bring jobs back to the coalfields and the Highlands.
$32.5 million for the Southwest Virginia Inland Port. Todd has led the Oak Park project in Washington County from a $200,000 feasibility study to $20 million for construction in the 2026 budget.
$7 million to finish the Coalfields Expressway. Paired with $3 million federal to complete four-laning U.S. 460 in Buchanan County (2026).
Created the Coalfields Expressway Authority as a Delegate (HB 2474, 2017).
$26.5 million to clean up the Bristol landfill. Delivered after Todd pressed the issue in three straight budgets — DEQ assistance in 2022, $2 million in 2023, full remediation funding in 2024.
Hard Rock Bristol. Carried the legislation and co-sponsored the 2020 law that put the casino on the ballot — approved by 72% of Bristol voters, now sending more than $13 million a year to 14 Southwest Virginia localities, including every one in the 6th District.
Lower Appalachian Power bills. Co-sponsored the Apco Rate Reduction Act (2025).
Kept coalfield roads funded. Extended the gas severance tax that pays for coal-and-gas road improvements and VCEDA — twice (2017, 2019).
Blighted properties back to use. Gave Bristol and other localities new tools to turn derelict buildings into homes and businesses (SB 1476, 2025).
Passenger rail to Bristol. Put a Southwest Virginia seat on the Virginia Passenger Rail Authority board (SB 725, 2022).
$3.5 million for child care. Secured funding for United Way of Southwest Virginia's initiative so parents can get back to work (2022).
Results for Southwest Virginia
Cutting Taxes & Fighting for Taxpayers
Voted for Youngkin's 2022 tax cuts. Eliminated the state grocery tax, sent rebates to every taxpayer, and exempted military retirement pay.
Largest tax relief in 15 years. Voted for the 2019 plan that nearly doubled the standard deduction.
NO on the gun and ammo tax (2026).
Protected coal tax credits. Voted NO on sunsetting the credits that keep Southwest Virginia miners working (2021).
Tax relief for small business. Passed a sales tax exemption on protective equipment during COVID (SB 1403, 2021).
Fighting for first-time homebuyers. Introduced a $5,000 first-time homebuyer tax credit (SB 747, 2026).
Results for Southwest Virginia
Health Care for Rural Virginia
As the only dentist in the General Assembly — and a provider who still treats Medicaid patients every week — Todd knows what rural families go through to get care. The Virginia Rural Health Association has named him Lawmaker of the Year twice, in 2017 and 2025.
30% raise in dental Medicaid rates. Secured $116 million so more Virginia dentists accept Medicaid (2022).
Reopened Lee County Community Hospital. Championed the return of a hospital that had been dark for eight years — one of the only rural hospitals in America ever to reopen (2021).
Southwest Virginia's first 24/7 crisis center. Secured the start-up funding for the Bristol crisis receiving center (2022).
Banned pharmacy “gag clauses.” Pharmacists can now tell patients when paying cash is cheaper than their copay (HB 1177, 2018).
Protected independent pharmacies from abusive PBM audits (HB 2561, 2019).
Opened the door to telehealth. Let out-of-state providers treat Virginia Medicaid patients remotely (SB 1418, 2023).
Built the dental workforce pipeline. Allowed foreign-trained dentists to teach at Virginia dental schools, created an expedited licensure pathway, and launched a new dental hygiene program for Southwest Virginia (2022–2026).
$1 million for dental hygiene training and $20 million for career and technical education at community colleges in the 2026 budget.
Protected the vulnerable. Added rare diseases to newborn screening (HB 1174, 2018) and banned disability discrimination in organ transplants (SB 846, 2020).
Results for Southwest Virginia
Education, Parents & Students
Parents' right to know. Voted to require parental notification of sexually explicit classroom material (SB 656, 2022) and against the Democrats' repeal of parental notification laws (2024, 2026).
Protected girls' sports. Supported keeping biological males out of girls' sports and locker rooms, and keeping CRT and divisive concepts out of classrooms (2022–2026).
School choice. Supported education savings accounts and lab schools to give parents more options (2022–2023).
Kids back in class. Voted to require in-person instruction and end school mask mandates (2022).
Safer schools. Required school safety audits to be done with local law enforcement (SB 600, 2022).
Chairman, Southwest Virginia Higher Education Center. Opened a new $1.8 million Regional Simulation Lab for nurses and first responders in 2026.
Investing in UVA Wise. Secured renovation of Darden Hall in the 2026 capital budget and planning funds for a new technology classroom building.
More trade credentials. Raised the workforce credential grant so more Virginians can earn a credential at community college (SB 1422, 2023).
Broadband for every student. Required school divisions to identify every home without broadband so state dollars reach them (SB 724, 2022).
Excused absences for 4-H. A bill inspired by a Wise County teen (SB 596, 2022).
Fewer SOL tests. Fought to cut standardized testing to the federal minimum (2018, 2020, 2021).
Results for Southwest Virginia
Backing the Blue & Keeping Communities Safe
Life for cop killers. Mandatory life sentence for the capital murder of a law enforcement officer (HB 2615, 2019).
Drones for police. Gave law enforcement drone and search-warrant authority to catch fleeing suspects (SB 647, 2026).
Tough on gangs and fentanyl. Supported Governor Youngkin's and Attorney General Miyares' crackdown on gangs, organized retail theft, and fentanyl as a weapon of terrorism (2023).
NO on abolishing the death penalty (2021) and NO on the 2020 “defund-the-police”-era reforms.
A statewide child abuse hotline. Created it and gave the state power to fix failing local social services departments (SB 640, 2026).
Protected seniors with multidisciplinary adult-abuse teams (HB 2560, 2019).
Pay for deputies. Pushed for a minimum salary for deputy sheriffs in fiscally stressed counties (SB 1085, 2020).
Results for Southwest Virginia
Coal, Energy & Appalachian Heritage
NO on the Clean Economy Act and RGGI (2020).
Protected coal tax credits. Voted NO on sunsetting them (2021).
All-of-the-above energy. Coal, natural gas, nuclear, and renewables.
A seat at the table. Member of the Virginia Commission on Coal and Energy and the Tobacco Region Revitalization Commission.
Safer mines. Strengthened coal mine tracking and fire-sensor requirements (HB 2257, 2015).
Shared energy revenue. Created a revenue-sharing agreement among eight coalfield localities for a pumped-storage hydroelectric project (HB 1555, 2018).
Results for Southwest Virginia
Outdoors, Parks & Tourism
$4 million for the Natural Tunnel pool. Rebuilding the Scott County landmark (2024).
$2 million+ for Breaks Interstate Park. Restored the historic lodge and Rhododendron Restaurant, funded the park's first dedicated ranger, and nearly tripled annual state support.
$466,500 for the Mendota Trail. Restored the railroad trestles — and pushing for a new state park in Washington County.
$2–3 million a year for Spearhead Trails. State support for the region's ATV trail system.
$800,000 for the Carter Family Fold. Marketing funds for the Scott County music landmark (2023–2024).
Heart of Appalachia Tourism Authority. Renamed and funded the region's tourism agency (SB 1399, 2021).
Awards & Recognition
Lawmaker of the Year, Virginia Rural Health Association (2017 and 2025)
Virginia Chamber of Commerce Innovation Award (2017)
Healthcare Hero, Virginia Hospital & Healthcare Association (2017)
Child Advocate Award, American Academy of Pediatrics – Virginia Chapter (2017)
Award of Merit, Virginia Pharmacists Association (2018)
Alumnus of the Year, Lincoln Memorial University (2022)
100% Rating, Virginia Citizens Defense League (2020–2025)