THE WINDOW OF OPPORTUNITY IS CLOSING FOR VA MEDICAID EXPANSION

In February, Virginia's work on the Commonwealth's biennial spending plan budget came to a halt because of the inclusion of provisions for Medicaid expansion. In short, the Republican House backs expanding Medicaid while the Republican Senate does not. Due to the divided GOP support, the regular session was adjourned and no budget was successfully passed. Virginia Governor Northam (D) compelled legislators to deliver as soon as possible. He warned that if a proposal was not drafted and on his desk in the near future, he would submit a budget that expanded Medicaid without some of the compromises made with Republicans; such as, imposing co-pays and work requirements.

Northam stated, "We've obviously compromised. If I send an amendment down, and I will if I need to, some of those compromises won't be in there and it will be closer to the original proposal in the budget Governor McAuliffe and I introduced."

McAullife's budget was rejected last December. The failed budget proposal had provisions for Medicaid expansion without conditions like work requirements or co-pays.

In an attempt to assist low-income citizens, Governor Ralph Northam followed through on his warning and revealed his proposed budget last week. He will deliver it to the Virginia General Assembly on April 11. According to the Virginian governor, the plan mirrors McAullife's plan but it will also incorporate an amendment created to invest in a revenue reserve fund.

Northam states, "Virginians have waited long enough for a balanced budget that expands health care access and invests in economic opportunity through education, workforce training, mental health and addiction services, and better pay for public servants. The General Assembly will return on April 11th to pass the budget Virginians deserve, but we shouldn't wait until then to get to work. My team and I are ready to work with the General Assembly money committees to get Virginia families, local governments, institutions of higher education and many others the certainty and resources they deserve by passing a budget that expands health coverage."

Under Gov. Northam's budget, Medicaid expansion would be available to almost 400,000 citizens. As a result of savings from the expansion, investments could then be made into workforce development, opioid addiction prevention, education, mental health services, and increases in pay for state workers. Additionally, the amendment would direct revenues that exceeded those predicted in the budget to a revenue reserve fund. This investment would serve to provide the state additional financial security in economic downturns.

According to Northam, "The budget I am introducing makes a strong investment in our Commonwealth's cash reserves. However, in a period of unprecedented volatility in Washington and economic uncertainty across the globe, we should do everything we can to shield Virginia taxpayers against an unexpected revenue shortfall. By including this amendment we can maintain a fiscally conservative budget and send a message to Virginians and to the rating agencies that this budget will invest wisely while also preparing for unexpected downturns."

After the budget was introduced, House Republicans went on the record claiming that the governor's proposal is "the start of a process that we are confident will lead to the adoption of a new budget long before July 1."

After the announcement, Senate Majority Leader Thomas K. Norment (R) criticized the proposal when Northam characterized it as a guide for discussion. Norment said, "That he (Gov. Northam) continues to make Obamacare's Medicaid expansion integral to that budget, and his refusal to base his plan on a more current revenue forecast means the current standoff can not be resolved quickly."

Medicaid's landscape continues to be a focus between Virginia's lawmakers in 2018. Due to the dispute among Republicans and Northam's recent proposal, it is unclear if Medicaid expansion will occur or if there will be work requirements and other conditions for eligibility. Legislators will reconvene in a special session on April 11 but if they do not successfully pass a budget, Virginia would have its very first government shut down.

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