Please review this summary of the latest on the budget process in Richmond and see the "Action Items" at the bottom of the page*
On Sunday, February 18th, the House and the Senate both released their 2018-2020 biennium budgets. The budgets varied drastically by more than $600M dollars, the biggest difference being the inclusion of Medicaid expansion in the House but not the Senate. The fiscal difference between the budgets may create a challenge during budget conference.
The House budget includes Medicaid expansion and several of the Governor's proposed budget items. The budget expands Medicaid in a two-part process:
- First, The Virginia Department of Medical Assistance Services (DMAS) is charged to amend the State Plan for Medical Assistance to expand eligibility and draw down federal funding.
- Second, the proposed budget requires the state to apply for an 1115 waiver with the federal Centers for Medicare and Medicaid Services (CMS) to implement a work requirement 180 days after the passage of the budget.
The Senate budget does not expand Medicaid and cuts over $400M proposed funding from the Governor's budget. The Senate budget proposes expanding coverage for people with Severe Mental Illness (SMI), Substance Use Disorder and complex medical conditions. The budget also moves the waiver population into managed care, funds the priority one waiting list and provides screening for Adverse Childhood Experiences (ACEs) in the FAMIS population. While well intentioned, the Senate budget does not mention how these priorities would be funded and does not draw down federal funding at the same rate the House budget proposes.
Next Steps for the Budget Bill Process
Next, the budgets will be debated on Thursday February 22nd. Traditionally, the House and Senate both adopt their own budgets and then reject the other body's budget. By February 28th both bodies will act on their respective budgets and appoint members for budget conference. The Senate conferees from last year are: Hanger, Norment, Ruff, Newman, Saslaw and Howell. In the House, the conferees from last year are: Jones, Landes and Torian. There are three vacancies for House conferees. The final budget will be presented 48 hours prior to adjournment.
Opportunities for Action for Medicaid expansion
The VBCF is a member of the Healthcare for All Virginians coalition, which has been advocating for Medicaid expansion since it was implemented as part of the Affordable Care Act. Providing access to health care for uninsured Virginians will mean that more people will be screened, diagnosed, and treated for breast cancer.
Additionally, with the House's version including over $400 million in funds that will be available with Medicaid expansion, their version of the budget provides more funds for K12 education and economic development opportunities. We see this as a win-win for all. Conversely, the Senate's version does none of these.
ACTION ITEMS:
- Thank House leadership and Delegates for inclusion of coverage expansion. Email your Delegate and ask him/her to vote yes on the House Appropriations Budget Amendments.
- Tell Senate members to invest in Virginia to provide healthcare coverage to 400,000 Virginians and fund public education and public safety priorities! Email your state senator and ask him/her to reject the Senate Finance Committee's budget that fails to provide health care access to 400,000 uninsured Virginians.
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