Republican leaders in the House of Delegates said Monday they believe a deal can be reached with the Senate allowing for Medicaid expansion in the commonwealth under provisions of the federal Affordable Care Act.
When the House and Senate passed their respective versions of the budget bill last week, the chambers both had provisions that detailed reforms to the state's health care program. Changes to health care for the poor must happen before the program can be expanded to 133 percent of the federal poverty level.
Under the Senate proposal the reforms -- such as implementing managed care throughout the program -- could begin when the Medicaid program is expanded starting in January 2014. The Senate plan allows Gov. Bob McDonnell to move forward if reform waivers are granted by the federal government.
The House plan requires reforms to be implemented in the existing Medicaid program and evaluated before the General Assembly approves expansion.
Del. Chris Jones, R-Suffolk, said the biggest difference between the two chambers is over who approves moving forward with Medicaid expansion. He said the Senate plan allows the governor to move ahead unilaterally, while the House plan requires General Assembly approval.
"I think we get there from here," Jones said.
Under the current House proposal the earliest the state could expand Medicaid would be July 2014 -- although many speculate a real start date would be July 2015.
Senate Democrats have drawn a line in the sand over the issue, saying they will not vote for a plan in the evenly divided chamber that does not include more immediate Medicaid expansion.
Jones was optimistic that a deal would be reached as a House and Senate conference committee on the budget begins meeting later in the week to hammer out a final spending package. He said senior lawmakers have already held preliminary discussions on the issue.
"I'm confident at the end of the day reforms will be what we deal with first," Jones said. "And then if we need to we can certainly come back later during the year to deal with the topic of the expansion of Medicaid."
House Speaker William Howell, R-Stafford, was also optimistic that a comprehensive transportation funding package would make its way through the General Assembly before the session ends next week.
Senate Democrats killed the Senate version of the transportation plan last week because it did not raise the estimated $1 billion in new funding needed to maintain and expand the state's failing transportation infrastructure. They also oppose McDonnell's proposal to increase the share of the existing general fund sales tax revenue from 0.5 percent to 0.75 percent.
But late last week Senate Minority Leader Richard Saslaw, D-Fairfax, said his caucus would work with Howell to pass a transportation plan.
Howell said the compromise plan may retain and index the state's 17.5 cent-per-gallon tax plan which democrats call for -- despite McDonnell's proposal passed by the House that eliminates the gas tax in favor of raising the sales tax.
"That could be a change," Howell said. "But it's not a question of the governor having to accept it. The governor wants to see a good plan come out just as each of us do."
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