According to a story from Politico, the two legislative bodies of the Virginia General Assembly, the House of Delegates and the Senate of Virginia, passed vastly different budgets last week, and a lot of it boils down to Medicaid expansion.
Medicaid expansion has generally been shown to be beneficial in many of states where it has passed, and it appears to be one of the core issues that resulted in the vast differences between the two budgets. Recently, the state’s government was considerably readjusted after the elections in November, which saw a new Democratic governor get elected. In addition, a great many more Democrats gained victory in the state legislature, narrowing the Republican majority significantly. A result of this is that a significant number of House Republicans have joined forces with Democrats to support Medicaid expansion, as well as other initiatives such as boosting student financial aid and pay raises for teachers.
Meanwhile, the state senate’s budget excludes the possibility of Medicaid expansion, despite the fact that the expansion would allow 400,000 Virginians to receive healthcare coverage. Republicans in the Senate typically excused their unwillingness by citing fiscal concerns and skepticism about the federal government’s ability to follow through. However, about nineteen House Republicans were persuaded to support expansion, including Kirk Cox, the current Speaker of the House of Delegates. Republicans that supported expansion cited similarities to the expansion plan that current Vice President Mike Pence approved as Indiana’s governor. The plan specifies work requirement for Medicaid recipients, for example. It also allows the state to withdraw from the expansion if the promised federal funding fails to materialize.
Now, the two legislative bodies are preparing for a showdown over expansion and whether it will make it into the final budget version, and it is possible that it could lead to a long-term impasse once the budgets head to conference committee. Medicaid expansion was a major component of the Affordable Care Act and aimed to loosen the requirements for eligibility. In states that choose to expand, the federal government is expected to cover 94% of associated costs in 2018, 93% in 2019, and 90% from 2020 and onward. The expansion could be a major boost for rare disease patients in the state that might be struggling with affording health insurance, which has become a major financial burden for many people.
