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Va. budget clears with expansion in Medicaid

Sunday, February 24, 2013


The end of the 46-day session of the General Assembly was not without drama in the Senate, as legislators sparred about Medicaid expansion and reform.

State Sen. Bill Stanley, R-Glade Hill, voted against the state budget primarily because of the Medicaid issue.

“I’m not against Medicaid expansion per se, but it can only be done in a way that reforms” the system, he said.

A proposal embedded in revisions to the two-year, $88 billion state budget called for expanding Medicaid to cover 400,000 more Virginians using federal funds. It created a 12-member commission to oversee Medicaid reforms and possible expansion.

By approving the expansion, “I think we've gotten the cart before the horse here,” Stanley said. Already about 21 percent, or $7 billion annually, of the state’s budget is spent on Medicaid reimbursements.

“I’m not against Medicaid expansion in theory, but I’m not for it until we get our fiscal house in order in Washington,” he said.

Delegates passed a version of the bill that called for reforms to be initiated and in place before coverage is expanded, according to Del. Don Merricks, R-Pittsylvania County. The Senate version of the bill was to expand and reform Medicaid “at the same time,” Merricks said.

But there is reported more than $60 million of fraud in the Medicaid system in Virginia alone, said Del. Danny Marshall, R-Danville. “Why wouldn't you want to fix that before adding a whole lot more money and people” to the system.

The federal government offered Virginia up to $9.9 billion to expand Medicaid, with plans to pay the cost for the first three years, Stanley said. Federal funds will be reduced gradually after the third year.

That funding also is a concern, because while the “federal government will pay 100 percent for the expansion now, but there are no guarantees it will continue” or for how long, Stanley said. Medicaid “is in dire need of reform and you cannot count on a promise from Washington that what they promise now will be delivered.”

“The lure of free money is not a lure at all and it’s not free, because it comes from our taxpayers,” Stanley said. “And ultimately, mark my words, Virginia will pay millions of dollars for a Medicaid expansion.”

The budget was passed after the proposal to expand Medicaid that Attorney General Ken Cuccinelli had ruled would be unconstitutional was tweaked. Democrats had said they would not give their crucial votes to the budget and transportation bills without assurance that the Medicaid expansion would be pushed through.

Cuccinelli ruled that lawmakers can’t delegate final legislative authority to a commission that would oversee cost-cutting reforms necessary to expand Medicaid is unconstitutional.

But a last-minute rewrite to the final budget compromise reached shortly before midnight Friday took away the commission’s discretion, making Cuccinelli’s ruling moot.

According to The Associated Press, other highlights of the state budget approved Saturday include:

• $70 million to fund the state’s share of a 2 percent salary increase for teachers and support personnel.

• $40 million for a 2 percent raise for state employees and a 3 percent raise for university faculty and state-supported local employees.

• $49 million to transfer an additional .05 percent of the sales tax to transportation.

• $7.7 million to provide services for 200 additional intellectually disabled and 50 additional developmentally disabled Virginians currently on waiting lists.

• $3.4 million to add 1,700 slots for in-state students at the College of William and Mary, the University of Virginia, Virginia Tech and James Madison University.

• $45 million in addition to the $50 million in the introduced budget for the state’s so-called “rainy day fund.”

• $30 million for public school security enhancements.

• $1.3 million for additional school resource officers.

• $150,000 for first-year startup costs for the Opportunity Educational Institution, which will take over chronically failing schools.

• $8.6 million for in-state undergraduate financial aid, along with $3 million to increase Tuition Assistance Grants from $2,000 to $3,100.


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