State budget proposals differ on Medicaid

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From The Roanoke Times

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RICHMOND — The Virginia Senate and House of Delegates set the stage for negotiations over expanding Medicaid on Thursday when they passed competing plans to amend the state's two-year budget.

The Senate approved a budget provision that would allow Virginia to expand Medicaid eligibility in January 2014 if the state agency administering the program can obtain federal approval of cost-containment reforms. At least 250,000 low-income Virginians could gain coverage if the state proceeds with Medicaid expansion under the Patient Protection and Affordable Care Act.

Gov. Bob McDonnell has said that he opposes expanding the state-federal Medicaid eligibility without reforms, and has questioned the federal government's ability to keep its funding commitment.

The Republican-dominated House of Delegates took a more deliberate approach than the Senate. It approved a provision that would require the federal government to approve the state's reforms before the General Assembly voted on authorizing expansion in its 2014 session. Democrats argued that would delay implementation and cost the state up to $3 billion in federal funds tied to expanding the program, which serves poor, disabled and elderly populations.

The federal government will pay for 100 percent of the increased Medicaid enrollment for three years beginning in 2014 and gradually reduce its share to 90 percent by 2020. Virginia would receive $23 billion in federal funds for the expansion through 2022. The state's cost over the same period would be an estimated $137.5 million.

The Senate's Medicaid provision won over Democrats who had voted against the budget plan in the Senate Finance Committee on Sunday. The full Senate passed its budget bill Thursday by a vote of 36-4.

"I would hope that we would seize this opportunity with enthusiasm and recognize it for the historic opportunity that it is," said Sen. John Edwards, D-Roanoke.

Sen. Emmett Hanger, R-Augusta County, said lawmakers have struggled with the political and financial implications of expanding Medicaid.

"If we can adopt this amendment, it will create a clear path forward for us to be able to do it Virginia's way; to reform Medicaid and, at the same time, provide the services that we want to provide, that our citizens require and demand, and under the provisions of the Affordable Care Act they will already be paying for," Hanger said.

In the House, Republican leaders said they remain reluctant to commit fully to Medicaid expansion.

"How on earth is that going to happen with a federal government that's not only broke, but is totally broke?" said House Majority Leader Kirk Cox, R-Colonial Heights.

The House passed its budget by a vote of 74-22. Each house will vote on the other's budget plan next week, and negotiators from the two chambers will work to reconcile differences between the bills. The bills revise the $86.5 billion budget that expires June 30, 2014.

The budget bills in both houses include funds to open the River North Correctional Center, a 1,024-bed facility near Independence. The prison was completed in 2010, but the state has not opened the facility because of budget constraints.

The Senate budget incorporates McDonnell's proposal to spend $14.3 million to open the facility next January. The House budget contains additional funds to allow the facility to open in October.

Both budget plans include pay raises for state workers, college faculty and public schoolteachers. The budget already includes a 2 percent raise for state employee that would take effect in August. The Senate plan would increase the raise to 3 percent, and the House plan includes $17.3 million to adjust pay for senior employees whose salaries lag behind the pay given to newer hires. Both plans would give 3 percent raises to college faculty.

Both budget plans include McDonnell's proposed 2 percent pay raise for teachers and additional funds to provide the same salary increase for school support staff.

Both budget plans extend a grandfather clause for school divisions that have state waivers allowing them to start classes before Labor Day. The Senate has killed separate legislation to give all school divisions the ability to start before the September holiday. But the Senate and House approved budget provisions that would extend waivers for the 2013-14 academic year. That could help Roanoke County and Roanoke schools, which are at risk of losing their waivers.

The Senate budget also strikes $600,000 that McDonnell had sought for a new statewide school board that would take charge of chronically failing schools. Both houses have passed bills to create the Opportunity Education Institution, but the Senate bill is conditioned on approval of state funds.

"I certainly hope and expect that we'll work it out in conference," said Del. Greg Habeeb, R-Salem, who sponsored the House bill.

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