Two key GOP senators now open to Medicaid expansion

April 06--Two Republican Senators are signaling a possible end to the standoff over Virginia's budget and Medicaid expansion, with one saying he will not vote for a budget that does not tap the additional federal money available for expansion.

Senate Finance Committee co-chairman Emmett Hanger, R-Mount Solon, broke with his caucus' staunch opposition to Medicaid expansion even though he said he still doesn't like the budget proposals that are pending.

Hanger said he has "no intentions of voting for a final budget that does not include a plan to access the additional dollars that are available to us currently under Medicaid."

"Those dollars came out of the pockets of Virginia taxpayers and we need to put them to use, particularly in rural Virginia," Hanger said.

Meanwhile, state Sen. Frank Wagner, R-Virginia Beach, said he'd vote to expand Medicaid if some key coverage issues for middle-income Virginians are met.

The entire 21-member state Senate Republican caucus, including Hanger and Wagner, had approved a budget that rejected Medicaid expansion and that carved out all the money the House of Delegates' budget proposed to save as a result.

Writing in a column for his local newspaper, The News Leader of Staunton, Hanger said he still has significant differences with some of the provisions in the budget proposals coming before the General Assembly when it meets for a special session on Wednesday.

But, he added, "I remain willing to negotiate terms."

That means tackling the lack of access to health care for low-income Virginians with what he called a pathway to self-sufficiency -- which is how House Republicans describe their plan for a work requirement as part of Medicaid expansion.

In addition, Hanger said he wants to see a plan to deal with soaring costs for other Obamacare coverage. Hanger also called for stricter regulation of health-care providers and insurers.

Wagner, meanwhile, told the Washington Post he is ready to vote to expand Medicaid under two conditions. One is that any expansion includes provisions to be sure Medicaid recipients would not suddenly lose coverage if their incomes rise above the cut-off. The other is some kind of financial help for people with higher incomes who can't afford standard Obamacare policies' premiums, co-payments and deductibles.

But that would come from a hospital tax as called for by the House. That levy is strongly opposed by Hanger.

Julian Walker, spokesman for the Virginia Hospital and Healthcare Association, said that while the group is open to the idea of using a hospital tax as part of Medicaid expansion, it believes that money should only go to Medicaid expenses, including reducing the deep discounts of hospital fees Medicaid currently demands.

"Sen. Wagner has identified a critical issue facing Virginia families and businesses today -- the ever escalating growth in health insurance premiums," Walker said. "However, data indicates that while the price of hospital and physician care is only rising between 1 percent and 2 percent per year, in the past year alone commercial health insurance premiums on the individual market in Virginia rose between 34 percent and 81 percent. We look forward to working with Sen. Wagner to address this incongruity."

Senate Republican caucus leaders, who have firmly opposed the Medicaid expansion proposals in Gov. Ralph Northam's budget, as well as the version the House of Delegates approved during the regular session, said neither Wagner's nor Hanger's comments change anything.

"While Senator Wagner's plan may be well-intentioned, it is neither well-conceived nor well-designed. Giving some Virginians what would amount to a $20-per-month tax credit provides negligible assistance when people are dealing with multithousand-dollar deductibles and outrageous monthly premiums," Senate Majority Leader Thomas K. Norment Jr., R-James City County, and Senate president pro tem Steven Newman, R-Bedford, said in a joint statement.

But others didn't see it that way.

"The chances of securing the governor a big win on a Medicaid expansion vastly increased with two GOP senators appearing to join the Democrats," said Mark Rozell, dean of the Schar School of Policy and Government at George Mason University. "There remains some uncertainty as the two GOP senators have different qualifications about the House bill. But should a deal be struck, the governor gets what he wants, a budget likely is secured, and the Democrats claim that they kept faith with their voters who gave the party a kind of mandate in 2017."

"I think it also reveals a concern among some Republicans about possible continued electoral battering if they are seen as the party resisting popular sentiment on issue after issue -- be it gun rights, Medicaid, or passing a budget, to name some."

And Northam believes the two senators' comments "are very encouraging," spokesman Brian Coy said.

Ress can be reached by telephone at 757-247-4535

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