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Governor presses Medicaid changes

RICHMOND—Gov. Terry McAuliffe is continuing to press the General Assembly on Medicaid expansion.

In a package of budget proposals released Monday, McAuliffe included a provision that would give him authority to expand Medicaid eligibility if the legislative panel studying the issue doesn’t act by the end of this session.

McAuliffe isn’t making formal budget amendments, but gave the chairmen of the two legislative budget committees a list of his amendment proposals on Monday.

Those proposals include additional money for state police to pay for gas, and money for localities to partially cover cost-of-competing funding for school support staff in Northern Virginia localities, including $10,759 for Fredericksburg, $122,360 for Spotsylvania and $143,108 for Stafford. He also wants to budget $4.6 million to local schools that saw their state education funding drop in the 2015 budget due to recalibrations of the funding formula.

McAuliffe said all of his budget proposals would be paid for by savings and don’t involve cutting other programs or looking at revenues.

They include an additional $15 million to the Literary Fund for teacher retirement and school construction loans. That money, said Secretary of Finance Ric Brown, comes from the one-time sale of some stock.

McAuliffe had mentioned wanting to time-limit the Medicaid expansion debate at his first speech as governor to the legislature last week.

He’s a strong supporter of the expansion, which would provide insurance coverage to up to 400,000 more Virginians and be paid for primarily through federal tax dollars. McAuliffe argues that Virginia should take advantage of that money, which is coming out of Virginians’ pockets, and that doing so would create jobs and protect hospitals from closing. Hospitals have started to lobby legislators on this point, too, with spreadsheets showing the cuts they’ve suffered under the Affordable Care Act and how Medicaid expansion could help make up for those cuts.

Many lawmakers, particularly conservative Republicans in the House of Delegates, disagree, insisting that the state spend more time seeking efficiencies and money-saving reforms in the Medicaid program before considering expansion. They’re also unwilling to rely on federal money.

McAuliffe told reporters he would rather the Medicaid Innovation and Reform Commission vote to expand Medicaid. But if they don’t hurry up, he said, he’d like to take over that decision.

“Time is of the essence,” he said.

McAuliffe said he’s had many meetings on the issue, with everyone from lawmakers to hospital CEOs.

“I’ve been working on this every single day,” he said

He said he’s open to variations on how expansion might look or work, and is sympathetic to Republicans’ fears that the federal government will renege on its obligation and leave Virginia holding the check.

“We do not want to take on any obligation that could affect our budget down the road,” McAuliffe said.

House budget leaders were unmoved by his proposal Monday.

“I do not see us expanding Medicaid this year,” said House Majority Leader Del. Kirk Cox, R–Colonial Heights.

McAuliffe’s proposal, he said, is “not going to change our position.”

He and other Republican lawmakers said the entire ACA is “flawed,” and suggested that they’re leery of anything to do with it.

Cox also said House lawmakers aren’t necessarily going to provide help in the state budget for hospitals, which are seeing losses from Medicare and other federal ACA cuts that they’d hoped would be made up by Medicaid expansion.

Chelyen Davis: 804/343-2245