The Washington PostDemocracy Dies in Darkness

Medicaid expansion gets off to a rough start in Virginia legislature

Sen. Emmett W. Hanger Jr. (R-Augusta) saw his Medicaid expansion bill voted down in committee Thursday, along with several others sponsored by Democrats. (Bob Brown/AP)

RICHMOND — If this is the year Virginia finally expands Medicaid, the effort got off to a rough start Thursday when a GOP-controlled Senate committee killed a package of bills on a party-line vote.

The chairman of the Senate Education and Health Committee warned several times before the vote that "this is only round one" of a long process. And the key battle over Medicaid is likely to come in the still-developing budget process in the House of Delegates.

But Thursday's committee action highlighted the party divide that remains even after the issue of expanding Medicaid helped drive big Democratic wins in the fall statewide elections. Polls show a majority of Virginians support expanding access to health care, and the hospital industry and several regional chambers of commerce have come out in favor of expansion.

"Whatever happens today will not be the end of this," committee chairman Stephen D. Newman (R-Bedford) said at the outset of Thursday's hearings on the matter.

The committee rolled several Medicaid-related bills into a single vehicle — one of them sponsored by Sen. Emmett W. Hanger Jr. (R-Augusta).

"I am a Republican," Hanger reminded the committee when presenting his bill, which would have tapped federal dollars to expand Medicaid and set incentives for able-bodied recipients to seek employment.

"There's a bit of tension in the air this year in terms of what we may or may not do," Hanger said, adding that he has "discovered that there is broad-based support for a common-sense solution" and that the matter should be bipartisan.

Former governor Terry McAuliffe (D) tried all four years of his term to expand Medicaid, but the Republican-controlled legislature always resisted. Voters erased most of a big GOP advantage in the House last year, with the GOP hanging on by 51 to 49 only after winning a random drawing in one tied district race.

Gov. Ralph Northam (D) succeeded McAuliffe in part on promises to finally get health care to as many as 400,000 low-income Virginians who would be eligible for an expanded Medicaid program under the federal Affordable Care Act. He supports McAuliffe's final budget proposal, which is balanced on some $400 million the state could save by accepting federal dollars to expand Medicaid.

McAuliffe takes one more swing at Medicaid expansion in final budget

The budget will be hashed out first in the House of Delegates, where quiet negotiations are underway and Republicans have sent signals that they're open to some form of health-care expansion.

But Thursday's debate in the Senate committee made clear that many Republicans are not sold on the idea.

"It's not whether or not we care about people; it's a matter of limited resources," said Sen. Amanda F. Chase (R-Chesterfield). She pointed out that Medicaid costs rise substantially every year and that obligating the state to greater coverage could jeopardize funding for other priorities such as education and transportation.

Chase said she would rather address the issue of "exploding" health-care costs before tackling Medicaid expansion.

Sen. Richard H. Black (R-Loudoun) agreed and said he worries that Congress could still kill the ACA, despite failing to do so in the past year. "I think it's premature to move forward on this and potentially get ourselves in a situation where we have expanded and have to do this thing on our own dime," he said.

But Sen. George L. Barker (D-Fairfax) pointed out that his bill contained provisions to stop the program if federal support ends. Others noted that the governor's budget proposal would pay costs not covered by federal money with an assessment on hospitals, leaving no net cost for the state.

The committee killed the bills on an 8-to-7 party-line vote. Newman, the chairman, noted that the panel would consider alternative proposals from Sen. Siobhan S. Dunnavant (R-Henrico) next week.