House Design Simple Plan

The stage is set for a showdown between the House of Delegates and Senate over expansion of Virginia’s Medicaid program, but the old roles have reversed in the five-year political battle.

The House Appropriations Committee reversed course on its longstanding opposition to Medicaid expansion on Sunday by adopting a proposed budget that would accept more than $3 billion in federal funding to extend health coverage for more than 300,000 uninsured Virginians.

The House plan, approved by a 20-2 vote, would seek simultaneous federal approval of reforms that would require Medicaid recipients to comply with work, education and training requirements, as well as pay a portion of their medical expenses. The votes against the proposed budget were cast by Dels. Charles Poindexter, R-Franklin County, and Chris Head, R-Botetourt.

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Later Sunday, the Senate Finance Committee, which had led previous efforts to expand health coverage under the Affordable Care Act, adopted a proposed budget that would not accept the enhanced federal Medicaid funding for expansion, but instead would focus on improving services to people with mental illness and addiction, while bolstering the state’s cash reserve.

The Senate budget, which the finance panel adopted unanimously, also laid out what it called “aspirational” goals for improving health care for a limited number of vulnerable Virginians. However, committee leaders acknowledged they have no way to pay for them because of a revenue hole of more than $421 million from the removal of Medicaid expansion, which then-Gov. Terry McAuliffe had included in the budget he proposed in December.

The two chambers will act on the spending plans on Thursday and the differences will be hashed out in a conference committee of members from the two money committees in the final weeks of the General Assembly session, which is scheduled to end March 10.

“I think it’s going to be a fascinating conference committee, and I’m really excited about it,” said Senate Majority Leader Tommy Norment, R-James City, who also is co-chairman of the Finance Committee.

Norment estimated the differences in available revenue between the two budgets at more than $600 million, primarily because of Medicaid, but also because the Senate proposes to put $180 million more than the House into a new cash reserve fund.

“I think this is the most conservative budget I’ve ever seen come out of the Senate since I’ve been here,” he said.

The House plan includes funding for accelerating 2 percent raises in the second year for state employees, teachers, and state-supported local employees such as sheriff’s deputies. It also proposes an additional 1 percent in merit raises for state employees, as well as targeted pay increases for nurses and direct-care staff at state mental hospitals, correctional officers at adult and juvenile facilities, marine resource officers, and deputies whose primary duties are law enforcement, rather than running jails.

The Senate plan includes a 2-percent raise state employees, teachers, and state-supported local employees for the governor to consider in his next proposed budget if the revenue is available.

The proposed House budget includes major new spending on education — from more than $91 million in additional dollars from the Virginia Lottery for local school districts to use as they please to $40 million to establish CyberX, a proposed higher education research initiative that Virginia Tech would lead from a Northern Virginia hub connecting to universities and colleges across the state.

The House plan represents the most significant in a series of bipartisan agreements between Republican House Speaker Kirk Cox, R-Colonial Heights, and Democratic Gov. Ralph Northam, who immediately endorsed the budget proposal for expanding Medicaid coverage as an “historic step.”

“I have long supported a simple and straightforward expansion of Medicaid,” Northam said in a statement on Sunday. “However, I respect the priorities of the House majority and I am encouraged by and supportive of our work together to bring about a new ‘Virginia Way’ on Medicaid.”

Cox, who became speaker in January after Republicans lost 15 House seats in the November election, said the plan represents a compromise that embodies most of the principles laid down by the GOP for its support of accepting enhanced federal funds for expansion.

“A lot of Republicans feel like the negotiations went very well,” he said in an impromptu news conference after the committee vote.

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