Could Medicaid expansion finally happen in Virginia?

NORFOLK, Va. - State lawmakers signaled they could be open to expanding Medicaid when House of Delegates leaders unveiled their proposed budget over the weekend. The proposed budget in the Senate does not expand Medicaid, setting up a possible budget showdown.

Expansion has been talked about for years in Virginia, but citing concerns over stability and cost, it has never happened. Gov. Terry McAuliffe said not getting it expanded was the biggest regret of his time as governor.

The proposal in the House of Delegates would expand Medicaid coverage to more than 300,000 people. The plan includes a work requirement for people getting the benefits and a "tax payer safety switch," which would end the expansion if the federal government ever backs out of its commitment to cover the cost.

"I've had questions about enhanced Medicaid, but I feel like where we are right now with the reforms we got, that's a solid package," said Del. Kirk Cox, the Republican House leader. "Overall with the budge, I'm extremely pleased."

Still, Senate Republicans, who have the majority at 21-19, remain skeptical of expansion. "Common sense suggests to me that there are so many uncertainties about Medicaid and Medicaid expansion right now that a more fiscally constrained approach is to not expand at this point," said Sen. Tommy Norment, a Republican from Williamsburg.

Gov. Ralph Northam has also been in favor of expanding. "I have long supported a simple and straightforward expansion of Medicaid. However, I respect the priorities of the House majority and I am encouraged by and supportive of our work together to bring about a new “Virginia Way” on Medicaid," he said in a statement. "We can and should expand coverage and provide significant training resources, counseling, and incentives to connect Virginians with employment opportunities."

Lawmakers in both chambers will now begin the process of finalizing the details before a vote later in the session.