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WEDNESDAYS • Feb. 21, 2018
Richmond & Hampton Roads
LEGACYNEWSPAPER.COM • FREE
Medicaid expansion may move forward in Va. Virginia’s Republican-controlled House of Delegates has created a draft state budget that expands Medicaid, dropping years of partisan resistance in the face of pressure from newly empowered Democrats. The House plan, recently approved by the Appropriations Committee on a 20-to-2 vote, would impose requirements that Medicaid recipients seek work training and contribute to their coverage through private insurers as a condition of receiving health coverage through the program aimed at aiding lowincome individuals. In addition, Congress failed to kill the Affordable Care Act, which is what enables Medicaid expansion. Two people involved in budget negotiations said Republican leaders had polled their members in the House last week to see whether they should include Medicaid expansion. A majority said yes, partly because of support from delegates in the southwestern part of the state, where poverty and hospital closures have made health care an urgent issue. Senate Majority Leader Thomas
K. Norment (R-James City), cochairman of the finance committee, said he expects “very spirited discussions” when the House and Senate attempt to reconcile their competing plans. “This House of Delegates has had an epiphany or is going through a cultural revolution over there,” Norment said. noting how unusual it was for the Senate’s spending plan to be more fiscally conservative than the one proposed by the more traditionally conservative House. Gov. Ralph Northam (D) had called for straight Medicaid expansion, as his predecessor — Terry McAuliffe (D) — had advocated during all four years of his administration. McAuliffe’s final budget recommendation, which Northam is now carrying, was built on saving about $400 million by accepting federal dollars to expand Medicaid. Northam also signaled a willingness to compromise, as he praised the House plan. “I respect the priorities of the House majority and I am encouraged by and supportive of
our work together to bring about a new ‘Virginia Way’ on Medicaid,” Northam said in a statement. “We can and should expand coverage and provide significant training resources, counseling and incentives to connect Virginians with employment opportunities.” Northam said he looks forward to working with the House and Senate to finalize the plan, even though he may face a steep climb in the Senate. Democrats on the Senate panel voted for the budget plan but expressed disappointment it did not include Medicaid expansion. The shift in the House gave them hope that expansion will eventually be part of the budget, but some were frustrated that Senate leaders continue to resist. The House plan would set aside about $21.5 million over the next two years for setting up the job training program for Medicaid participants. The proposal would allow Virginia to extend Medicaid coverage to residents who earn up to 138 percent of the federal poverty level, with 300,000 people expected to be added
to the rolls. It would go into effect by Jan. 1, 2019. There would have to be a federal waiver to implement the job training requirement, but Republicans said they believed the Trump administration would look favorably on the waiver request. The plan would use health savings accounts to help new recipients participate in private insurance coverage, with cost-sharing provisions and incentives to keep up healthy behaviors. Nine categories of people would be exempt from the work or job training requirement, including pregnant women, children and people with major disabilities or who care for someone with a major disability. The House budget would use Medicaid savings to fund a host of other programs, including the pay raises for teachers and other state employees; setting aside $247 million for a state reserve fund; and financing $350 million to deepen channels in the port in the Norfolk area.