Virginia General Assembly votes to expand Medicaid

Published: May. 30, 2018 at 3:16 PM EDT
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UPDATE (8:20 p.m.):

Virginia's governor is set to sign legislation in coming days expanding Medicaid after the state's Republican-controlled General Assembly ignored warnings from the White House against expanding the health care program for the poor.

The state Senate voted Wednesday in favor of a state budget that expands Medicaid. The House, which had had previously endorsed expansion, gave its final approval shortly thereafter. Several Republicans in both chambers joined with Democrats to approve the measure.

Ironically, Republican lawmakers said it was the Trump administration's embrace of work requirements for low-income people on Medicaid that help get the measure passed after years of partisan battles.

Expanding Medicaid was a key provision of then-President Barack Obama's health care overhaul, which President Donald Trump has vigorously sought to negate. White House officials, including budget director Mick Mulvaney, urged Virginia lawmakers this year not to expand Medicaid. Trump's recent budget proposal calls for repealing Medicaid expansion, and Mulvaney said the administration is "committed to addressing the unsustainable growth" of the program.

But Virginia GOP Speaker Kick Cox said the Trump administration's openness to conservative reforms, including work requirements, "was probably the biggest key" in getting Republican support for Medicaid expansion this year.

And a failure by the GOP-led Congress to repeal and replace the health law helped spur several Republican state legislators to flip positions.

"There's always talk of repealing Obamacare; that did not happen," Cox said.

Democratic Gov. Ralph Northam's expected signature should enable roughly 400,000 newly eligible low-income Virginias to begin enrolling in Medicaid at the start of next year. A tally from the Kaiser Family Foundation shows Virginia will become the 33rd state to approve Medicaid expansion

The Senate passed it 23-17, with four Republicans joining the Democrats. The House endorsed it about an hour later with a lopsided 67-31 vote.

It took more than four years of battles over whether Virginia should expand the publicly funded health care program for the poor. In 2014 and again this year, the fight led to standoffs over the state budget.

But Republicans took notice when Democrats campaigned heavily on expanding Medicaid last year and made unexpectedly large gains, reshaping the state legislature in an anti-Trump wave. Some were eager to take the issue off the table before next year's election, when both House and Senate seats are up

Virginia Democrats have argued the state should not pass up the roughly $2 billion in extra federal funding the program would bring to the state. Republicans had previously been near unified in blocking past expansion efforts, saying the long-term costs were unsustainable.

In the final hours, Sen. Ben Chafin, a Republican lawmaker from Virginia's economically depressed southwest coal country, announced his support for expansion on the Senate floor. He said his rural area needs expansion to bolster its hospitals and provide care for constituents.

"I came to the conclusion that no just wasn't the answer anymore," Chafin said.

Several Republican senators remained strongly opposed, saying Medicaid costs would eventually overwhelm the rest of the state's budget needs for schools and public safety.

"It is a ticking time bomb," said GOP Sen. Bill Stanley.


ORIGINAL (May 30):

Virginia's lawmakers have taken a step closer to expanding Medicaid.

On Wednesday, the commonwealth's Senate voted 23-17 to approve a budget for the state that includes Medicaid expansion.

This comes after months of delay ahead of a budget deadline for the state government.

The bill now heads to the House of Delegates, who voted for Medicaid expansion earlier this year, to be approved.

If delegates again vote in favor of the bill, which had amendments added by the Senate, it would head to Governor Ralph Northam's desk.

One of Northam's major campaign goals was to expand Medicaid for Virginia — a goal his predecessor, Terry McAuliffe, had but could not achieve with Republican majorities in the General Assembly.

The expansion would open Medicaid to about 400,000 low-income adults in Virginia.

A tally from the Kaiser Family Foundation shows Virginia will become the 33rd state to approve Medicaid expansion. Expanding Medicaid was a key provision of the Affordable Care Act pushed by former President Barack Obama.

Democrats have pushed unsuccessfully for years to expand Medicaid in Virginia. Several state Republicans, including Augusta County's Emmett Hanger, dropped their opposition this year, saying the state would be better off with increased federal funding for the program.

“I’m thrilled that the Virginia Senate has decided partisan politics should no longer stand in the way of thousands of Virginia families getting the healthcare they need," said Sen. Mark Warner. "I look forward to the House of Delegates soon doing the same. Governor Northam and supporters of Medicaid expansion should be proud of this bipartisan achievement, but the real winners here are the hardworking Virginians who will finally have healthcare for their families.”


Virginia lawmakers are set to end a budget stalemate and pass Medicaid expansion.

Both chambers of the Republican-controlled General Assembly are scheduled to meet Wednesday to take up a state budget plan that expands the publicly funded health care program for the poor. About 400,000 low-income adults would be newly eligible.

Democrats have pushed unsuccessfully for years to expand Medicaid in Virginia. Several state Republicans dropped their opposition this year, saying the state would be better off with increased federal funding for the program.

Pro-expansion lawmakers have a majority in both chambers, and Democratic Gov. Ralph Northam is a strong proponent of expansion.

A tally from the Kaiser Family Foundation shows that Virginia will become the 33rd state to approve Medicaid expansion.

Governor Northam Statement on Biennial Budget that Expands Health Care and Invests in a Stronger Economy


RICHMOND—Governor Ralph Northam today issued the following statement on the General Assembly’s passage of a budget that includes Medicaid expansion, which will increase healthcare access for up to 400,000 Virginians:

“Today the General Assembly sent a budget to my desk that will improve the lives of all Virginians. It will expand health care for up to 400,000 people who need it. It will invest in schools, workforce training, public safety, and an economy that works better for every Virginian, no matter who they are or where they live. 


“This budget is the culmination of five years of effort to bring our taxpayer dollars home from Washington and expand Medicaid. As a doctor, I’m so proud of the significant step we’ve taken together to help Virginians get quality, affordable care. 

“This budget doesn’t just expand healthcare access to those who need it most, it also invests in core economic priorities like education and workforce training and significantly increases the cash reserves that insulate our state finances from economic disruption. 

“This is the best reflection of what we can accomplish when we do things the Virginia Way, and I want to thank the Virginia Senate and House of Delegates for their good faith efforts to come to this historic agreement.

“The loudest voices in this long-standing conversation on Medicaid expansion have been those of Virginians. We have heard you. Thank you. I also want to acknowledge Governor Terry McAuliffe for his unrelenting effort to expand healthcare access while he was in office, and every member of the General Assembly who stood up today and did the right thing for their constituents. This is a victory for all Virginians.


“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.”



Statement of House Speaker Kirk Cox on House passage of 2018-2020 state budget

Virginia House of Delegates Speaker Kirk Cox (R-Colonial Heights) issued the following statement Wednesday after the House of Delegates voted to accept the Senate amendments to House Bills 5001 and 5002, passing the state budget. The budget bills will now go directly to Governor Ralph Northam for his signature. 

“The House of Delegates acted Wednesday to complete the work we started six weeks ago, passing House Bills 5001 and 5002 and sending them to Governor Northam for his signature. The balanced budget we adopted includes no new general fund taxes, replenishes Virginia’s reserve funds, invests in our people, and reflects our multi-year effort to grow Virginia’s economy through responsible investments and prudent fiscal planning. 

“First and foremost, this budget replenishes various state savings accounts, a critical step necessary to preserve our prestigious AAA bond rating.The budget invests the entirety of the projected budget surplus in our reserve funds, including our constitutionally-required deposit to the rainy day fund and another significant deposit in our new short-term cash reserve. By the end of the biennium, Virginia should have close to if not more than $1 billion in our two primary reserve funds, a strong signal that our Commonwealth remains one of the safest investments in the country. 

“The budget also includes what I consider the most conservative set of reforms to Medicaid in the nation as part of a plan to expand healthcare coverage to working Virginians. Our plan gives hard-working people a path to self sufficiency through a robust work requirement, empowers them to be part of their healthcare decisions, and safeguards taxpayers by both requiring hospitals to fund the future cost of expansion and including an automatic safety switch to disenroll people if the federal government fails to keep its commitments. 

“Throughout the entirety of this process, my position on Medicaid has never wavered. I remain concerned about the long-term fiscal impacts of expansion, but the simple truth is there were never enough votes in the House or Senate to block some form of Medicaid Expansion. When I was elected Speaker, I committed to lead the House as a governing body, not a political one, and when confronted with that reality we crafted a plan that guarantees conservative reforms that would not have otherwise been realized. 

“Healthcare is just one way this budget invests in our people. We are funding a three percent teacher pay raise and fully-funding our public schools, with over $480 million in new classroom spending. The budget also includes a two percent pay raise for our state employees and raises the minimum salary for our sheriff’s deputies to $32,500. Keeping with our conservative theme, all of our compensation actions are contingent on the state meeting projected revenues; if the money isn’t there, Virginia will not spend it.

“We are also building on our past efforts, investing in higher education degrees that promote a strong workforce. We are increasing funding for our workforce credential program, incentivizing colleges to offer degrees in high-demand fields, making significant investments in our Port, and increasing funding for broadband deployment in rural and underserved areas. These are incremental but significant efforts to better position our citizens for long-term economic success. 

“Despite all of the noise of the last six weeks, the General Assembly has fulfilled its constitutional duty and produced a balanced budget that charts a prudent fiscal course for our Commonwealth. As we look toward the work ahead, I hope we can move forward in a manner that is worthy of the people we serve.”