Virginia lawmakers at impasse on Medicaid expansion

RICHMOND, Va. (AP) — Virginia lawmakers aren’t going to pass a budget on schedule this year, the second time in four years that disagreements over Medicaid expansion have led to a stalemate.
Republican House Appropriations Chairman Del. Chris Jones said Thursday that the House and the Senate will not be able to come up with a compromise state budget by Saturday, when the 2018 session is set to end.
Lawmakers assigned by both chambers to work on a compromise have no future plans to meet, Jones said, because neither side is willing to budge on Medicaid expansion. After years of near-uniform opposition, Republicans are now split on the issue with the GOP-led House supporting Medicaid expansion while the GOP-led Senate opposes it.
Without an agreement on Medicaid expansion and a corresponding hospital tax to pay the state’s share, the two sides are far apart on how much money they’ll have to spend. The House version has significantly more money for public education and gives raises to state employees, something the Senate version does not.
“We’ve already dealt with all that we can,” Jones said.
The state government will shut down if no budget is passed by July 1, but Jones said he expects a budget pass before then. He added that a break from the capital could help dislodge the logjam.
“When you go back home you get a better feel for what your constituents want you to do,” Jones said.
But most Republicans in both chambers still oppose Medicaid expansion, and leaders in the state Senate said going home isn’t going to change their mind.
“The position of the Senate is likely to be the same because that’s what our constituents have been telling us to do,” said GOP Sen. Steve Newman.
A federal-state collaboration originally meant for poor families and severely disabled people, Medicaid has grown to become the largest government health insurance program, now covering 1 in 5 people. Under former President Barack Obama’s health law, states got the option of expanding Medicaid to cover more low-income adults.
Virginia is one of 18 states that have refused. Former Democratic Gov. Terry McAuliffe tried unsuccessfully to force the issue in 2014, leading to a prolonged budget stalemate that Republicans eventually won. His successor, Democratic Gov. Ralph Northam, has made expansion a top priority.
The reversal of several top Republicans on Medicaid came after Democrats — fueled largely by voter antipathy toward President Donald Trump — made large gains the state House last year. Pro-Medicaid expansion Republicans have said they were also swayed by the Trump administration’s embrace of work requirements for some Medicaid recipients.
Northam said he will continue to work with lawmakers to get a budget passed that “includes expanded health access as soon as possible.”