Medicaid Expansion Approved by Virginia General Assebly

Ralph Northam on inauguration day 2018.

In a major triumph for Governor Ralph Northam and Virginia Democrats - not to mention the tens of thousands of working Virginians who will benefit - the Virginia General Assembly has approved Medicaid expansion.  The move will end Virginia's export of taxes that have accrued to adjoining states which previously embraced Medicaid expansion, an aspect of the Affordable Health Care Act which Congressional Republicans have worked to kill with no regard for the millions of Americans who will be harmed through either a loss of health insurance coverage or significantly increased health insurance premiums all so the 1% could reap obscene tax cuts.   Many of Virginia's rural hospitals, especially in Southwest Virginia where bigotry and religious extremism make it difficult to attached a new industrial base, that have been teetering on bankruptcy  or closure, will be among the big winners on this development.   Here are highlights from the Virginian Pilot:

The Republican-controlled Virginia General Assembly gave final approval Wednesday evening to a state budget expanding Medicaid coverage to the state's poor, acting swiftly after the Senate broke years of partisan gridlock on the issue.

The House of Delegates voted Wednesday only about an hour after the state Senate voted in favor of expansion. Several Republicans in both chambers joined with Democrats to support Medicaid expansion.

The House had previously endorsed expansion, while the Senate had held out in opposition until Wednesday.

Democratic Gov. Ralph Northam is expected to sign the budget in coming days that continues the plan. Expanding Medicaid was a key provision of then-President Barack Obama's health care overhaul, and a tally from the Kaiser Family Foundation shows Virginia will become the 33rd state to approve Medicaid expansion.

Senate passage came by a 23-17 vote with four Republicans joining Democrats for passage. The House quickly followed about an hour later with a lopsided 67-31 final endorsement.

Wednesday's voting marked the end of a more than four-year battle over whether Virginia should expand the publicly funded health care program for the poor. 

Virginia Democrats have pushed for years to expand Medicaid, saying their state should not pass up the roughly $2 billion in extra federal funding the program would bring to the state.  Sen. Ben Chafin, a Republican lawmaker from Virginia's economically depressed southwest coal country, announced his support for expansion on the Senate floor. He said his rural area needed expansion to help bolster its hospitals and provide care for constituents in need.  "I came to the conclusion that no just wasn't the answer anymore," Chafin said.

Expanding Medicaid to cover more low-income families was a key provision of the Affordable Care Act secured by then-President Barack Obama.

A federal-state collaboration originally meant for poor families and severely disabled people, Medicaid has grown to become the largest government health insurance program, now covering 1 in 5 people. Obama's health care overhaul gave states the option of expanding Medicaid to cover more low-income adults.

The GOP-controlled General Assembly's support for Medicaid comes despite Trump administration rejections.

Last year, Virginia saw its state legislature reshaped by an anti-Trump wave as Democrats made unexpectedly large gains in the state House. And a failure by the GOP-led Congress to repeal and replace the health law helped spur several of Virginia's Republican state legislators to flip positions.

Democrats campaigned heavily on expanding Medicaid last year and some House Republicans were eager to take the issue off the table before next year's election, when both House and Senate seats are up.