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Medicaid expansion on life support in Virginia

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Plans to expand Medicaid in Virginia may not be dead on arrival at the General Assembly, but they’re struggling for life support.

“It’s such a big new entitlement at a time when we need to be looking hard at the cost of entitlements,” House Speaker William Howell told Watchdog.org in an interview.

Howell and his fellow Republicans, who hold a veto-proof lock on the House and regained a majority in the Senate, rebuffed efforts to expand Medicaid last session.

But with Democratic Gov. Terry McAuliffe continuing to push for expansion, Howell agreed to convene a special session Sept. 18 for further debate.

GOP Delegate Tom Rust, R-Herndon, has broken ranks with a Medicaid proposal of his own. Howell says it will get a hearing, but he remains staunchly opposed to expansion.

“The Rust bill relies on a lot of federal money, which Washington doesn’t have. When the government is $17 trillion in debt, it can’t continue to pay 90 percent of (Medicaid expansion) forever,” said Howell, R-Falmouth.

The speaker is equally skeptical about provisions allowing Virginia to opt out, or modify the program if the D.C. cash flow stops.

“The federal government isn’t granting many waivers,” Howell said. “Even if they did, how do you write a letter to people saying you don’t have insurance anymore?”

With Virginia facing a $2.4 billion budget shortfall, Howell criticized Republican state Sen. John Watkins’ bid to expand Medicaid.

“Watkins’ plan is a huge new entitlement,” Howell said.

The Midlothian senator, who has Democrats’ support, wants to cover every Virginian — including able-bodied, working-age residents — whose individual income does not exceed 133 percent of the poverty level ($15,282).

The 133-percent threshold applies only to children up to age 18 and pregnant women. Liberalizing the rules would add 400,000 mainly healthy adults to the Medicaid rolls at a cost of roughly $1 billion a year.

While pledging full and open hearings during the special session, Howell said he does not see a viable compromise. Nor does he buy into projections by the liberal Commonwealth Institute that a bigger, unreformed Medicaid system will pay for itself.

The veteran lawmaker also dismissed the notion that McAuliffe could expand Medicaid by executive order. The governor has directed Secretary of Health Bill Hazel to draft a plan by Monday.

“McAuliffe’s biggest problem is that if there’s no legislation, he can’t do it on his own. He can’t spend a dollar if it hasn’t been appropriated,” the speaker said.

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