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Virginia Republicans Divided on Medicaid Expansion, Budget

On their way to morning meetings early Thursday, budget conferees didn’t have much to report on reconciliations between the GOP-controlled House budget that includes Medicaid expansion and the GOP-controlled Senate budget that doesn’t.

But it did sound a bit like a zoo.

“The big elephant in the room is to begin to deal with money issues, and a lot of that is going to center around how we deal with Medicaid expansion,” said Democratic Delegate Luke Torian.

“It’s the elephant in the room for sure,” said Democratic Delegate Mark Sickles.

“That of course is the 800-pound gorilla in the room,” said Republican Delegate Barry Knight.

Senate Majority Leader Tommy Norment has even compared the negotiations to horse-trading, and fellow Republican Senator Emmett Hanger’s description isn’t far from that.

“We state our position, they state theirs…and we say, well we’re not going to give,” Hanger said. “And they say…well, we’re not going to give. And then we go away a while and then we say, well we’ve got to do something.”

Technically, the official deadline for legislators to reach a budget consensus is Saturday. But they’ve blown past that deadline in recent years, and they’re on track to do that again this year. Thursday morning, budget conferee and Republican Senator Frank Ruff saw the writing on the wall – since lawmakers are supposed to have final budget bills printed and ready for distribution 48-hours before they adjourn.

“It takes 24 hours to print the thing,” Ruff said.

Soon after that conversation, Republican Delegate Chris Jones – who has supported adding a work requirement to a Medicaid expansion plan in the House - made an announcement on the House floor that there won’t be a budget by Saturday….and likely not for at least a handful of days after that.

“I know you all are very anxious to know what we’re going to be doing after Saturday,” Jones said. Jones proposed either extending the session for 30 days – or convening a special session to give legislators through June to reach an agreement.

Norment advocated for a special session on the Senate floor. “There is nothing nefarious going on,” he said. “There is nothing insidious going on.”

In an email newsletter to his constituents last Friday, Norment wrote that Medicaid expansion would not be a fiscally sound decision – despite the consensus of his Republican colleagues in the House. Others like Republican Senator Frank Ruff echoed that sentiment Thursday – especially with the current tax on healthcare providers baked into the House’s Medicaid expansion plan.

“Because that means that next year, the insurance companies will factor in that extra cost and raise your premiums to pay for something else,” Ruff said. “So we’re trying to avoid getting into that kind of situation.”

Virginia’s Hospital and Healthcare Association estimates the provider tax will cost about 70 hospitals altogether a total of 300 million over the biennium.

Republican Senator Emmett Hanger doesn’t support the provider tax, either – but he has spoken out in support of Medicaid expansion. In an email to his constituents last Saturday, he said he feels like it’s the right thing to do. “At this point…Senator Hanger holds most of the cards, so…we’ll see,” said Democratic Senator Janet Howell, speaking after the initial Senate and House budgets were approved.

But Republican Senator Stephen Newman says Medicaid expansion is a non-negotiable. He doesn’t believe any other Senate Republicans will be willing to budge on the issue at all.

“20 of us in the Senate have been very clear that we are not in favor of expanding Medicaid, so I think that right now we’re holding strong,” Newman said.

Republican Delegate Chris Peace says there has been some agreement on other issues.

“We’re trying to identify our common denominators in all of the areas – whether it’s transportation, or K-12 or higher education, or healthcare and eliminate those areas of agreement,” Peace said.

However, there won’t be a dollar amount for any of those items until legislators stop monkeying around and finally confront the elephant in the room.