Highlight on Virginia: Compromise Might Be the Right Medicine for Health Coverage

Eight months after blocking expansion of Virginia’s Medicaid program, House Republicans are proposing a $124 million health care package which doesn’t propose to expand Medicaid, but it does expand behavioral health care for people with serious mental illness and it provides additional funding for free clinics and community health centers.

The Republican alternative to Democratic Gov. Terry McAuliffe’s “A Healthy Virginia” proposal expands prescription drug coverage to all beneficiaries and provides services to 30,000 mentally ill Virginians, which is 10,000 more than the program McAuliffe established by executive order last year after Republicans blocked his Medicaid expansion plan.

The House plan also would fund two other pieces of the Health Virginia plan that McAuliffe announced in September in response to the General Assembly’s refusal to expand Medicaid. It would provide dental care for pregnant women in the Medicaid and FAMIS programs, as well as allow low-income state employees to secure affordable health care for their children under FAMIS, or Family Access to Medical Insurance Security.

Status quo. Up until this point, Virginia hasn’t experienced much progress with expanding health coverage. In the spring of 2014, the majority of Virginians favored the Medicaid expansion, however, the 2014 legislative session ended without any decision on Medicaid expansion. The indecision led to a budget stand-off and required a special session of the General Assembly. As the special session began, Governor McAuliffe announced a revised proposal for a two-year “pilot program,” which would end with the 100 percent federal funding. McAuliffe presented written assurances from CMS that Virginia could end its Medicaid expansion after two years with “no financial penalty and no reduction” in the percentage of federal matching funds the state would receive. McAuliffe said he would take the responsibility if Medicaid expansion does not continue after the two-year pilot.

Last fall, Governor McAuliffe via executive authority launched “A Healthy Virginia” to provide additional health coverage to some Virginians. A Healthy Virginia is a 10-step plan that includes the authorization of four emergency regulations and one executive order to expand coverage. Part of the plan requires a CMS waiver, and the plan will lose funding at the end of July 2015 unless the General Assembly approves its continuation.

In a December update to the state Joint Money Committees, McAuliffe stated that he “remain[s] committed to providing health care coverage to up to 400,000 uninsured Virginians who are still waiting for their leaders to expand Medicaid eligibility.”

With this new piece of legislation being introduced by the Republicans, maybe there is room for some cooperation and expansion of coverage.