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Bolling supports Medicaid expansion — if reforms allowed

In a reversal of his earlier position, Lt. Gov. Bill Bolling announced today that he thinks Virginia should expand its Medicaid eligibility under the federal Affordable Care Act.

But, Bolling said, he only wants the expansion if it’s accompanied by federal waivers to let Virginia “effectively reform Medicaid.”

In a letter to lawmakers, Bolling said he now supports the expansion because of new information — namely, an estimated savings to the state by expanding Medicaid coverage, and a study that indicated the expansion could create up to 30,000 new jobs.

He also cited a revised cost estimate from the Gov. Bob McDonnell administration — while the governor initially estimated the expansion would cost more than $2 billion, earlier this month that number was revised down to about $137 million over nine years.

Bolling said numerous business groups support the expansion, and he has become convinced it will help save doctors and hospitals the cost of caring for people who are uninsured.

“With this more complete picture of of the business case for Medicaid expansion in hand, it is my view that the right public and fiscal policy for the commonwealth is to move forward with the proposed expansion of Medicaid, conditioned on our ability to obtain authority from the federal government to implement acceptable reforms to our Medicaid program,” Bolling said.

The ACA encourages states to expand their Medicaid programs, with the federal government paying the full cost for the first few years and 90 percent thereafter. In Virginia, the expansion would provide health coverage to about 420,000 of the state’s estimated 1 million uninsured.

But many Republicans, including McDonnell, have said they don’t trust the federal government to keep that promise, particularly when the nation is deeply in debt and when Congress is fighting over how to cut spending to lessen debt and deficit problems.

McDonnell has also said he won’t advocate expanding a program that he feels is broken and over which states have little control.

Bolling said his support for the expansion is conditioned on the federal government’s ability to pay, and on the ability to enact unspecified reforms to the program. He and McDonnell have both in the past expressed frustration that Medicaid, which costs states an increasing amount of money, is a federal program that limits state control over how it is administered.

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