The Window of Opportunity Is Closing for VA Medicaid Expansion

Virginia Medicaid Expansion Debate

26 Mar The Window of Opportunity Is Closing for VA Medicaid Expansion

Last month, Virginia’s work on the Commonwealth’s biennial spending plan budget came to an abrupt halt due to the inclusion of provisions for Medicaid expansion. In short, the Republican House supports expanding Medicaid whereas the Republican Senate does not. As a result of the split GOP support, the regular session was adjourned and no budget was passed. Virginia Governor Northam (D) urged legislators to deliver as soon as possible. He warned that if a proposal was not drafted and on his desk in the near future, he would submit a budget that expanded Medicaid without some of the compromises made with Republicans; such as, imposing co-pays and work requirements.

Northam stated, “We’ve obviously compromised. If I send an amendment down, and I will if I need to, some of those compromises won’t be in there and it will be closer to the original proposal in the budget Governor McAuliffe and I introduced.”

McAullife’s budget was rejected last December. The failed budget proposal had provisions for Medicaid expansion without conditions like work requirements or co-pays.

In an effort to help low-income citizens, Governor Ralph Northam followed through on his warning and introduced his proposed budget this week. He will present it to the Virginia General Assembly on April 11. According to the governor, the proposal reflects McAullife’s plan but it will also include an amendment designed to invest in a revenue reserve fund.

Northam says, “Virginians have waited long enough for a balanced budget that expands health care access and invests in economic opportunity through education, workforce training, mental health and addiction services, and better pay for public servants. The General Assembly will return on April 11th to pass the budget Virginians deserve, but we shouldn’t wait until then to get to work. My team and I are ready to work with the General Assembly money committees to get Virginia families, local governments, institutions of higher education and many others the certainty and resources they deserve by passing a budget that expands health coverage.”

Under Northam’s budget, Medicaid expansion would be available to almost 400,000 citizens. As a result of savings from the expansion, investments could then be made into workforce development, opioid addiction prevention, education, mental health services, and increases in pay for state employees. Furthermore, the amendment would direct revenues that exceeded those forecasted in the budget to a revenue reserve fund. This investment would serve to give the state additional financial security in economic downturns.

According to Governor Northam, “The budget I am introducing makes a strong investment in our Commonwealth’s cash reserves. However, in a period of unprecedented volatility in Washington and economic uncertainty across the globe, we should do everything we can to shield Virginia taxpayers against an unexpected revenue shortfall. By including this amendment we can maintain a fiscally conservative budget and send a message to Virginians and to the rating agencies that this budget will invest wisely while also preparing for unexpected downturns.”

After the budget was introduced, House Republicans went on the record stating that the Governor’s proposal is “the start of a process that we are confident will lead to the adoption of a new budget long before July 1.”

After the announcement, Senate Majority Leader Thomas K. Norment (R) criticized the proposal when Northam described it as a guide for discussion. Norment said, “That he (Gov. Northam) continues to make Obamacare’s Medicaid expansion integral to that budget, and his refusal to base his plan on a more current revenue forecast means the current standoff cannot be resolved quickly.”

Medicaid’s landscape continues to be a focus among Virginia’s legislators in 2018. Due to the disagreement among Republicans and Northam’s most recent proposal, it is not clear if Medicaid expansion will take place or if there will be work requirements and other conditions for eligibility. Lawmakers will reconvene in a special session on April 11 but if they do not pass a budget, Virginia would have its first government shut down.