State lawmakers expand Medicaid coverage as part of new state budget

RICHMOND, Va. -- Virginia lawmakers voted to expand Medicaid coverage to low income Virginians under the Affordable Care Act. The expansion vote was a part of the two-year state budget set to take effect July 1. More than 300,000 uninsured Virginians, who do not qualify for ACA subsides, will be granted access to the Medicaid program.

State Senator Emmett Hanger (R - Augusta) helped push through a budget that included Medicaid expansion after the House of Delegates previously passed a similar budget bill.

Virginia Republicans had long opposed accepting federal funding to expand the Medicaid program over fears that the federal government would repeal the program and leave Virginia on the hook for paying the cost of expansion.

A majority of Republican Senators still opposed expanding Medicaid, arguing that expanding the program would drive up health care costs for every Virginian and wreck the financial future of the Commonwealth.

Senate Republicans said Sen. Hanger’s budget bill was not fiscally conservative.

In the end, a handful of Republican Senators joined every Senate Democrat to vote in favor of expanding Medicaid.

The budget bill included a work requirement for able bodied adults that will receive Medicaid coverage in Virginia.

Health care advocacy groups praised the move and said low income Virginians who cannot afford health care coverage will finally receive access to care without jeopardizing their financial future.

The House of Delegates, which has previously voted in favor of expanding Medicaid as a part of the budget, and Governor Northam have to finalize the budget bill.

Northam released a statement Wednesday following the Virginia Senate’s passage of the new budget.

“Today a bipartisan group of leaders in the Virginia Senate voted to make history and make people’s lives better,” Northam wrote. “The budget the Senate passed today expands health care to Virginians, invests in core economic priorities and strengthens the cash reserves we need for a rainy day. By passing this budget, the Senate made a clear statement that Virginia is a place where leaders still work together to get things done for the people who send us here.”

“Going forward, my team and I will review this budget when it reaches my desk to ensure that there are no technical issues or unintended problems that may warrant an amendment and act upon it as quickly as possible,” he added.

Wednesday's vote came after Sen Hanger (R-Augusta) and Delegate Chris Jones (R-Suffolk), state budget negotiators, hammered out amendments to the House budget plan they believed would pass both chambers.

The amendments include a provider assessment fee on state hospitals that will generate revenue to pay for Virginia's share of the cost of expanding Medicaid.

"This document, and all that it does for Virginia, speaks for itself as a conservative, responsible blueprint that replenishes our cash reserves to protect our AAA bond rating, invests in teachers, state employees, sheriff’s deputies, expands healthcare access for low-income Virginians, expands on Early Childhood Education by increasing the Virginia Preschool Initiative’s per pupil funding and provides financial incentives for provisionally licensed teachers to become fully licensed, and builds on the General Assembly’s multi-year effort to encourage sustained economic growth," Jones wrote in a letter House members outlining the amendment package.

The Richmond-Times Dispatch first reported the agreement.

The House of Delegates had already passed a budget package that included a plan to expand Virginia's Medicaid program to low-income Virginians who make up to 138 percent of the federal poverty level. The House plan included a work/training requirement for able bodied adults 18-55 who receive Medicaid coverage in Virginia.

Senate Majority Leader Tommy Norment (R-Williamsburg) had pushed for passage of a "clean budget" that did not include federal funding to expand Medicaid under the Affordable Care Act (ACA).

After the passage Wednesday, Norment released a statement calling the deal "disappointing."

“Today, the General Assembly approved a budget that abandons Virginia’s long-standing reputation for fiscal responsibility,” said Norment. “This budget marks a stark departure, both from the conservative fiscal policies observed by the Commonwealth for generations and in the manner in which it was approved by the General Assembly.”

The Senate Majority Leader said the deal will not discourage him from continuing to fight for a fiscally responsible budget.

“We will be ready to resume that fight when we convene for the next regular session in January 2019,” he added.

The Virginia Hospital and Healthcare Association also released a statement Wednesday calling the expansion of Medicaid coverage “an important step” on behalf of many Virginians.

“Today, the Commonwealth took an important step on behalf of many Virginians. In completing its work on the state budget, the General Assembly is fulfilling its duty to fund a wide range of essential public services on which millions of citizens rely," said VHHA President and CEO Sean T. Connaughton. "The budget’s inclusion of a bipartisan compromise plan to draw down available federal funds to help hundreds of thousands of hard-working, uninsured Virginians gain health care coverage will promote public health improvements, job growth, economic vitality, and strengthen our health delivery system. Reaching this point has taken years of hard work and considerable effort by many elected leaders, stakeholders, advocates, and everyday Virginians who each made valuable contributions in support of increased coverage. Members of Virginia’s hospital community extend sincere thanks to all those who have been instrumental in this effort. In particular, we offer our gratitude to House of Delegates Speaker Kirk Cox, House Appropriations Committee Chairman Chris Jones, Senate Finance Committee Co-Chairman Emmett Hanger, Governor Ralph Northam, Senate Minority Leader Dick Saslaw, Senator Frank Wagner, Senator Ben Chafin, Senator Jill Vogel, House Minority Leader David Toscano, and the dozens of other individual Senators and Delegates from both parties who supported the compromise budget. Just as the hospital community has been a consistent partner with the state to achieve a compromise coverage plan, our members pledge continued support to the Commonwealth as we work together to implement coverage expansion here as part of the ongoing work to make Virginia the healthiest state in the nation.”