Medicaid expansion still unresolved in General Assembly

Published: Apr. 11, 2018 at 5:04 PM EDT
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Virginia lawmakers briefly returned to the Capitol on Wednesday to kick off a new round of negotiations over whether to expand Medicaid. But there was little actual movement on the issue, or any sign of when there might be a resolution.

Legislators left town after voting to start a new special session devoted to passing a state budget, a move necessary before lawmakers can resume negotiations on Medicaid in earnest. The GOP-led General Assembly failed to pass a state spending plan during its regular session earlier this year because of disagreements over whether it should include Medicaid expansion.

After a Republican senator switched sides last week, there is now a majority of lawmakers in both chambers who support expansion. Proponents are more optimistic than ever.

"It'll take a while, but it'll happen," said Democratic Sen. Dick Saslaw.

But key differences remain among expansion supporters — including whether to enact a related hospital tax — and opposition among many Republicans remains strong.

"There are some people that are truly dug in on the issue," said Republican Sen. Bryce Reeves.

Medicaid is a federal-state collaboration that's become the largest government health insurance program. Under former President Barack Obama's health law, states had the option of expanding Medicaid to cover more low-income adults. In Virginia, about 400,000 adults would be newly eligible for coverage.

Virginia Republicans have in past years blocked Democrats' efforts to expand Medicaid, saying its long-term costs are unsustainable. But after a GOP-led Congress was unable to repeal Obama's health care law and a wave of elected Democrats reshaped the state House last year, several Republicans switched positions.

That includes House Speaker Kirk Cox, who said the House is working on strengthening work requirements for Medicaid recipients to match what the Trump administration has approved in other states. Cox said details would be unveiled Friday when the House Appropriations Committee meets.

The full House is expected to pass its version of a budget Tuesday, and Cox said he wants to see a resolution "sooner rather than later."

But a final deal on the budget could be several weeks away.

Republican leaders in the Senate have indicated they want to wait until new state revenue figures are released next month before finalizing a budget. State government will shut down if no budget is passed by July 1.