The 2014 regular session of the Virginia General Assembly was adjourned Saturday without members of the House of Delegates and Senate finalizing the commonwealth's two-year budget or resolving the politically-charged issue of Medicaid expansion.
Following adjournment, Gov. Terry McAuliffe (D) quickly called a special session beginning March 24 to finalize the budget and, hopefully for McAuliffe and Democrats, find a way to make the Medicaid expansion happen.
In a letter to delegates and senators, McAuliffe stated he intends for the session to last three weeks. He reiterated his oft-used pitch for expansion, saying it will bring more than 400,000 uninsured Virginians into the Medicaid rolls.
“The House and Senate need to find common ground on a path forward that funds the priorities most important to Virginia families, including bringing their money home to keep people healthy, creating up to 30,000 jobs and helping net the commonwealth $1 billion by 2022,” McAuliffe said.
Medicaid expansion, which is one branch of the federal Affordable Care Act, has been a hot-button item in Richmond since last year's session, when the House and Senate agreed to exclude the Medicaid debate from the budget.
In recent weeks, many Republican delegates have pushed for passage of a “clean budget” that didn't include Medicaid expansion. Lawmakers on the right have been united in their opposition to the expansion.
“Overall it was a very successful session, yet unfortunately the job is not complete,” Del. David Ramadan (R-87th) wrote in an email. “We leave Richmond today without a biennial budget because the Governor and the Senate have injected Medicaid into the process. This is wrong. Virginia's budget is not a bargaining chip. Regardless of how you feel about Obamacare, holding hostage the funding for our schools, teachers, police officers, firefighters and local governments is wrong.”
The Affordable Care Act-loathing Republicans also expressed skepticism the federal government will make good on its promise to pay for 100 percent of expansion costs the first three years and 90 percent thereafter. Moreover, GOP leaders fear the escalating health care costs will bust the commonwealth's budget.
"Even without expansion, Medicaid is one of the largest and fastest-growing parts of Virginia's operating budget,” local Del. Tag Greason (R-32nd), who opposes expansion, said last month. “Medicaid has grown from 5 percent of the state budget to more than 21 percent. This was already a cause for concern, but adding 248,000 to 400,000 more to the Medicaid rolls will jeopardize the entire system.”
Last year, both General Assembly chambers agreed to establish the Medicaid Innovation and Reform Commission (MIRC), which has yet to complete its work and has requested an external audit of Medicaid, according to Ramadan.
Democrats consistently refused to separate the issue from the state's proposed $96 billion biennial spending plan.
“It is impossible to separate a major program like Medicaid from the budget deliberations,” House Democratic Leader David Toscano (D-57th) said in a prepared statement. “We are losing $5 million a day of our constituents’ money while leaving thousands of Virginians without access to health care they need; the sooner we decide to act, the sooner we can utilize this money to help our people and our communities.”
Twenty-five states plus the District of Columbia have agreed to expand Medicaid.
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