Virginia Set to Expand Medicaid, as Senate OKs Proposal

Virginia is set to end a yearslong partisan battle and expand Medicaid after the state Senate voted Wednesday to approve a budget that expands the program's eligibility to about 400,000 low-income adults.

The Senate passed Medicaid expansion by a 23-17 vote with four Republicans joining Democrats for passage.

The budget still needs final approval from the House and Democratic Gov. Ralph Northam. But that's expected to happen with little difficulty.

Virginia will become the 33rd state to approve Medicaid expansion, according to a tally from the Kaiser Family Foundation.

Wednesday's vote marked the end of a more than four-year battle over whether Virginia should expand the publicly funded health care program for the poor. A fight over Medicaid expansion led to a standoff over the state budget in 2014 and again this year.

Sen. Ben Chafin, a Republican lawmaker from Virginia's economically depressed southwest coal country, announced his support for expansion on the Senate floor. He said his rural area needed expansion to help bolster its hospitals and provide care for constituents in need.

"I came to the conclusion that no just wasn't the answer anymore," Chafin said.

But several Republican senators remained strongly opposed, saying Medicaid costs would eventually overwhelm the rest of the state's budget needs for schools and public safety.

"This is raising the cost of health care and will do nothing to help the people of Virginia," said GOP Sen. Mark Obenshain.

Expanding Medicaid to cover more low-income families was a key provision of the Affordable Care Act advanced by former President Barack Obama.

Virginia Democrats have pushed for years to expand Medicaid, saying their state should not pass up the roughly $2 billion in extra federal funding the program would bring to the state. Republicans had previously blocked past expansion efforts, saying the long-term costs were unsustainable.

President Donald Trump has sought to negate his predecessor's health law — but ironically, his administration's embrace of work requirements for low-income people on Medicaid prompted lawmakers in some conservative states to resurrect plans to expand health care for the poor.

A federal-state collaboration originally meant for poor families and severely disabled people, Medicaid has grown to become the largest government health insurance program, now covering 1 in 5 people. Obama's health care overhaul gave states the option of expanding Medicaid to cover more low-income adults.

The GOP-controlled General Assembly's support for Medicaid comes despite Trump administration rejections. Virginia saw its state legislature reshaped by an anti-Trump wave last year, as Democrats made unexpectedly large gains in the state House. And a failure by the GOP-led Congress to repeal and replace the health law helped spur several of Virginia's Republican state legislators to flip positions.

Democrats campaigned heavily on expanding Medicaid last year and some House Republicans are eager to take the issue off the table for next year's election, when both House and Senate seats are up.