Update on the Virginia Medicaid Expansion Debate

13 Apr Update on the Virginia Medicaid Expansion Debate

Lawmakers in Virginia were unable to approve the Commonwealth’s biennial spending plan earlier this year; which included provisions for Medicaid Expansion. Due to a divide in Republican support within the House and Senate, the legislators agreed to reconvene for a special session, which took place Wednesday. Leading up to the session, in an effort to persuade Republican Senate support for Medicaid expansion, House Speaker M. Kirkland Cox (R) proposed strictly enforcing work requirements. He recognizes the concerns of conservatives but also appreciates the need for healthcare for the 400,000 uninsured Virginians. Regarding the work requirements, Kirkland stated, “We’re going to look at that and try to, you know, strengthen that somewhat. I think among conservatives that’s something that’s very important.”

Despite the divided support in the last regular session, some legislators that had opposed expansion are now reconsidering supporting it. One of those who had previously been against expansion is Senate Majority Leader Thomas K. Norment Jr. (R). His willingness to support expansion is contingent on a more conservative approach and it would need to be developed collaboratively. In an interview with WCVE radio, Norment said, “if, in fact, there is going to be a fiscally responsible and conservative Medicaid expansion plan, it has got to be developed on a more collaborative basis. One person can’t develop that plan, come in and drop it down in front of 21 Republican senators and say, ‘Here it is.’ That is not going to work.”

In order to approve a budget and expand Medicaid, legislators will need to have their plan drafted by July 1 or the state will experience its first government shutdown.

Senate Minority Leader Richard L. Saslaw (D) says, “This is something that should have been done three or four years ago, but better late than never. Between 350,000 and 400,000 Virginians will get the health care that’s needed.”

This week’s two-hour special session focused primarily on procedural moves. The next step will be to address Governor Ralph Northam’s (D) newly proposed budget bill that he presented in between the sessions.  It will make its way through the House and Senate finance committees and then onto the chambers for voting. Finally, a conference will be held to sort out any remaining details between the House and Senate. It will require two Republicans to pass Medicaid expansion within the Senate; however, only one vote from Republicans is required to pass it in the form of a budget amendment.

According to Governor Northam’s projections, savings due to Medicaid expansion will be around $421 million. The House would like to see funds invested into education, raises for teachers, and other areas so they estimate the savings from expansion to be closer to $307 million as a result of varying start dates.

In the past, Virginia’s Republican representatives have not supported Medicaid expansion, but in recent months it’s starting to look like that will change. While the Republican Senate did not hold elections last year, the chamber nearly lost its majority to Democrats in November. As a result of the coming elections and the need for support from voters to retain control of the House, Republicans are now making efforts to convert Republican opposition to support Medicaid expansion.