As Medicaid-expansion states go, Virginia is bringing up the rear, signing on long after most states that opted to enlarge the federal-state insurance program for the poor. Northam appeared to be referring to the bipartisan compromise that finally made expansion possible after years of GOP resistance.
The General Assembly voted earlier this year to add up to 400,000 uninsured, low-income Virginians to the state’s Medicaid rolls. Coverage kicks in Jan. 1, but it was unclear until Thursday when people could start enrolling.
Federal officials notified the state last week that they had signed off on Virginia’s expansion, clearing the way to move ahead.
Washington has not yet approved the state’s plan to customize its program by imposing work requirements and co-pays on recipients — requirements that were essential to winning support from some Republicans. The state needs a federal waiver to put those things in place, but Virginia will implement expansion in the meantime.
Under the Affordable Care Act, passed in 2010, Washington allows states to open their Medicaid rolls to people with incomes up to 138 percent of the federal poverty level. That amounts to $16,750 a year for an individual and $28,700 for a family of three. The federal government pledged to pay at least 90 percent of the cost, which in Virginia would amount to about $2 billion a year.
Thirty-two states plus the District took up the offer. But Virginia, with an existing Medicaid program that is one of the country’s leanest, resisted for four years despite the urging of then-Gov. Terry McAuliffe (D).
Northam ran for governor last year on a promise to expand, winning in a blue wave that nearly wiped out the GOP’s 2-to-1 advantage in the House of Delegates. With Republicans in control of the House and Senate by just one vote, Democrats were able to get expansion out of the General Assembly with just a few Republican defectors.