This week the General Assembly will resume a special session called by the Governor last March to complete work on the Budget. At the end of the last regular session the State Senate and the House of Delegates were at an impasse over the budget, because House Republicans refused to include provisions to expand Medicaid coverage under the Affordable Care Act. Ultimately, with the resignation of State Senator Phil Puckett the General Assembly passed a budget without Medicaid expansion which the Governor signed.

In exchange for the votes of some moderate Senators, the Speaker of the House, William J. Howell, promised to hold an additional special session to talk about Medicaid Expansion and ways we might close the health care coverage gap for Virginians earning between 100 and 138 percent of the federal poverty level. This gap is a by-product of the Affordable Care Act that was intended to be closed by expanding Medicaid coverage. The Supreme Court has ruled that Medicaid expansion must be approved on a state by state basis.
Since the General Assembly left session in March, 2014 a lot has happened.

Conservative states like Arizona, with a Republican Governor, found ways to expand Medicaid. As a result, Arizona has experienced a 3.2% decline in its uninsured rate, after it found a way to recapture tax dollars paid to the federal government and bring them back to support almost 200,000 who did not have coverage.

In New Hampshire their governor and legislature found a way to bring back $2.7 billion to close the coverage gap for 50,000 by passing its Health Protection Program, a New Hampshire Way. Just this August, Pennsylvania, with Republican Governor Tom Corbett at the helm, found a Pennsylvania way to close the coverage gap for 600,000 residents and bring back $2.5 billion in federal monies to that state. Meanwhile, in Virginia, we have lost over $1 billion since January, 2014, by not finding a Virginia Way.
The 24 states that have not yet expanded stand to lose $423.6 billion from 2013-2022.

Hospitals in these states stand to lose $167.8 billion – that’s billion.

In Virginia, they project a 10 year loss at $14.7 billion and hospital loss at $6.2 billion.

We cannot tell our taxpayers that we will send their taxes to D.C. and not get them back.

We need a plan. We have been promised one since January. We still haven’t seen one.

As we return for Session the Governor has endorsed yet another compromise plan offered by Herndon Republican Delegate Tom Rust. This proposal would provide workers with access to insurance through employer plans Premium assistance, or vouchers, provided for workers to purchase employer-sponsored insurance. Individuals without access to employer-sponsored insurance who made less than 100 percent of the federal poverty level would be offered insurance provided through Medicaid managed care plans, wellness programs and care coordination to improve quality of care. Individuals without access to employer-sponsored insurance who earn between 100-133 percent of the federal poverty level would qualify for Premium subsidies for the purchase of health insurance on the Federal Marketplace based on the cost of a silver-level plan.
This would all be funded through a Virginia Health Care Independence Taxpayer Recovery Fund.

Unfortunately, the plan would sunset on December 31st, 2016 if the Medicaid Innovation and Reform Commission doesn’t vote to continue it. This is essentially the same deal legislators were offered in 2012. It turned out the MIRC was stacked with legislators opposed to Medicaid Expansion under any circumstances.

As we return to Richmond I will keep an open mind about this latest proposal, but will also be careful that, in the words of ‘60s British rockers, The Who, “We Don’t Get Fooled Again.”

Delegate Simon represents the 53rd District in the Virginia House of Delegates. He may be emailed at DelMSimon@house.virginia.gov.