Virginians receiving continuous Medicaid coverage was one of the benefits of a pandemic-era law, proving to be a lifeline to children and families and helping to bring down the overall uninsured rate. The provision however is set to expire on April 1, and the regular Medicaid renewal process will resume. Now, even eligible children could lose coverage due to difficulties in the renewal process, like staffing and lack of communication. Learn more in this “Medicaid Unwinding” vlog from Policy Analyst, Emily Moore.
For additional help, Medicaid enrollees can visit Enroll Virginia, enrollva.org/get-help or call 888.392.5132 to make a free appointment with a navigator. Navigators can help complete renewal forms, reapply for Medicaid, or transition to new affordable coverage through the Marketplace.
Head to Facebook to watch the recording of Enroll Virginia’s Facebook live event in English and Spanish from February 16, “The End of the Public Health Emergency and Medicaid: What You Need to Know.”
Virginia will start to review Medicaid members’ health coverage beginning in March 2023. They will not cancel or reduce coverage for members without asking for updated information, but they need your help to make this a smooth process. You can take steps now to make sure you receive information you will need to renew your coverage.
What Medicaid members can do now:
Update your contact information. You can make updates:
Nearly half of Virginia’s children are enrolled in Medicaid for their health insurance coverage. To ensure that these young people have access to mental health providers, and for those providers to adequately compensate staff, reimbursement rates for behavioral health must be increased this year.
Medicaid-funded services for children’s behavioral health has declined by $100 million since the beginning of the pandemic, largely due to the phase-out of Therapeutic Day Treatment Services in schools. While the dollar amount of funding has decreased, more children and youth have sought mental health services since the pandemic, meaning that services have not adequately kept pace with needs. Furthermore, only 14% of children on Medicaid are receiving behavioral health services, a significant gap below the need expressed in the general population of children and youth where 30% or more of young people express mental health concerns. Black and Latino children are disproportionately enrolled in Medicaid and report more barriers to accessing mental health care.
Medicaid reimbursement for children’s mental health services has declined by $100 million since the pandemic, despite an increase in children seeking services. (Bar on the far right does not represent a full year.)
The members of the General Assembly will consider several proposals to improve Medicaid reimbursement for behavioral health services. The options below can put Virginia on a path forward to bringing more behavioral health resources into schools and reaching more students who need mental health support.
Medicaid rates must keep pace with inflation and ensure adequate staff compensation.
Short-term solution: increase community behavioral health services rates in FY24
Support 304 #9s (Deeds)/304 #23h (Farriss): Medicaid Reimbursement Rates for Community-Based Behavioral Health Services
This proposal would provide:
25% rate increase for:
Intensive In-Home, Mental Health Skill Building, Psychosocial Rehabilitation, Therapeutic Day Treatment, Outpatient Psychotherapy, Peer Recovery Support Services — Mental Health.
10% rate increase for BRAVO services:
Comprehensive Crisis Services (which include 23-hour Crisis Stabilization, Community Stabilization, Crisis Intervention, Mobile Crisis Response, and Residential Crisis Stabilization), Assertive Community Treatment, Mental Health – Intensive Outpatient, Mental Health – Partial Hospitalization, Family Functional Therapy and Multisystemic Therapy.
And a long-term solution: conduct a rate study to determine inputs to delivering care and suggest a process for annual rate increases based on inflation.
Modernize reimbursement rates for school-based mental health.
Long-term solution: conduct a rate study on school-based mental health services to replace the currently offered service—therapeutic day treatment “TDT”. The future of behavioral health redesign planned to look at this service and develop new school-based services connected to multi-tiered systems of support in school.
Support Medicaid Rate Studies for Behavioral Health 308#7s (McClellan)/ 308#11s (Brewer)
This proposal provides a long-term solution to modernizing school-based mental health services and empowers young people to help design those services.
Youth voice/choice: this amendment specifies that students and school-based stakeholders must be involved in the design of school-based services.
Provide TA to School Divisions to Implement Medicaid Reimbursement
In a follow-up to the 2021 legislation proposed by Sen. Dunnavant to implement the “Free Care Rule” in Virginia, our state Medicaid agency has an application pending approval at the federal level to allow school divisions to bill Medicaid directly for school-based health and mental health services outside of a students’ IEP. This would enable school divisions to pull down a dollar-for-dollar match for the health services provided or initiated by schools. There is a catch though. School divisions will have to take on extra administrative tasks in order to seek reimbursement. This proposal allows DMAS to provide resources to DOE and school divisions to provide technical assistance and professional development to seek reimbursement.
SupportTechnical Assistance to School Divisions to Implement Medicaid Reimbursement Item 308#13s (McClellan)
While the entire world faces the COVID-19 pandemic, America and Virginia face dual pandemics, COVID-19 and racism as a public health crisis. Public health looks at how external factors influence health outcomes, such as how racism, poverty, food access, and environmental inequities collectively contribute to physical, social, and emotional health.The solutions require a multi-faceted response that promotes a multi-sector continuum of care. The pandemic has shed light on the importance of how one’s awareness of their own health can impact the entire community, such as knowledge that one is carrying the COVID-19 virus. This gives us the opportunity to do better in ensuring that our residents have fair and just access to what they need to sustain a quality of life and positive health outcomes.
Our talking points for the 2021 legislative session will focus on the following themes that fall under the umbrella of expanding insurance access to immigrant populations:
Extend Medicaid coverage for legally residing young adults from 18 to 21.
Extend eligibility for FAMIS Moms prenatal delivery coverage to all pregnant women.
Expand Medicaid coverage of “emergency” services for COVID-19.
Extend Medicaid Coverage to Immigrant Populations
Every Virginian should have access to health insurance during a pandemic, regardless of immigration status. When parents have access to health insurance, children are more likely to have insurance. As a result, the overall health and well-being of Virginia’s population is improved due to increased access.As of December 10th, according to the CDC, there have been over 285,000 deaths from COVID-19 in the United Status. This number continues to rise, but we must note the disproportionate impact of the pandemic on communities of color. Minority communities are expected to navigate systems of biases and inequities and stay afloat while facing exacerbated health inequities as it relates to the social determinants of health. Young adults are just starting off in life and often work part time jobs that have limited access to paid time off, such as sick pay and health insurance. Virginia must ensure they have what they need to survive the pandemic and live a long and healthy life.
Increase the age that legally residing immigrant children can qualify for Medicaid and FAMIS: Currently, legally residing immigrant children in Virginia qualify for coverage up to 19. Federal law allows optional coverage to continue up to age 21 allowing for continuity of care and reducing gaps in health coverage.
Extend Eligibility for FAMIS Moms Prenatal Delivery Coverage to All Pregnant Women, Regardless of Status
Policymakers must prioritize child and family health. It’s time to invest in and prioritize access to healthcare for all Virginians. The postpartum period is important but an often neglected element of maternal and infant care. Mothers deal with a variety of medical conditions and complications from birth, regardless of their identity. Symptoms include pain, childbirth, postpartum depression and anxiety, and more. As we navigate the public health crisis, every policy and funding decision should move Virginia closer to becoming a place where everyone has the opportunity to survive and thrive. Access to prenatal coverage improves health outcomes for the mother and child.
Extend Medicaid/FAMIS MOMS prenatal coverage to undocumented women who meet all other non-immigration eligibility criteria: The federal option for this is already in use in 17 other states and would require a CHIP plan amendment. However, the good news is extending prenatal coverage could result in 2.3 million in net savings for the state in FY22 due to drawing down a higher federal match rate compared to emergency services that might otherwise not be utilized due to a lack of access.
Expand Medicaid Coverage for COVID-19 Emergency Services
Communities of color are experiencing much higher COVID-19 hospitalization rates. For example, as of December 3rd, the Virginia Department of Health reported 15,116 hospitalizations. The Black community accounted for 29 percent, despite the fact that they represent just 19 percent of the commonwealth’s population. Similarly, the Latinx population represents 24 percent of Virginia’s COVID-19 hospitalizations, but only 9.8 percent of the population. Meanwhile, the white community accounts for 28 percent of the commonwealth’s coronavirus hospitalizations, but nearly 70 percent of the population. These numbers are disproportionate.
Virginia must expand Medicaid coverage for COVID-19 emergency services: Several other states have taken steps during the current crisis to help their residents regardless of immigration status. Federal law allows states to cover COVID-19 screening, testing, vaccines, and all related treatment for any immigrant who meets financial requirements for Medicaid, but does not meet the immigration status requirement. This policy will decrease the spread of the coronavirus. Virginians should have access to emergency services during a pandemic. It benefits everyone.
The Virginia General Assembly wrapped up its regular session this past March by passing a historic two-year budget that invested in Virginia’s children and families. COVID-19 hit Virginia at the exact same time—disrupting lives and upending our economy. New and urgent budgetary demands presented an unforeseen and unprecedented budget shortfall, forcing Governor Northam to make the tough decision to “Unallott” or freeze more than $2 billion in new spending, much of which was set to take effect this summer. When policymakers returned in August for a Special Session, Governor Northam released an updated budget proposal based on revised budget projections. Sadly, the budget outlook is grim and the Governor’s proposed budget strikes much of the new funding approved in March.
While the Governor’s new budget makes important investments to avoid evictions, it does not prioritize spending for important healthcare priorities that are critical to families during this time, including: Ensuring more moms have continuous health coverage for one year postpartum and removing barriers to healthcare for legal immigrants.
To meet the growing needs of children and families, the legislature must explore all revenue options including rainy day funds, new sources of state revenue and exhausting all federal funding opportunities.As the Legislature makes tough funding decisions during special session, policymakers should restore funding for the following health equity priorities:
Restore funding to eliminate Virginia’s “40-Quarter Rule” for legal immigrants
Federal law requires legal immigrants or Lawful Permanent Residents (LPRs) to establish five years of U.S. residency in order to access Medicaid coverage. Virginia also adds an additional obstacle for immigrants to qualify for Medicaid coverage: 40-quarter work requirement. This rule requires legal immigrants in Virginia, who meet income eligibility guidelines for Medicaid coverage, to prove 10 years of work history before qualifying for coverage. Virginia is only one of six states that still has this additional barrier for immigrants to qualify for coverage. This rule is particularly harsh on legally residing immigrant children and pregnant women who qualify for Medicaid for a period of time but lose it because they may not have 10 years of work history established.
Before the pandemic hit, Policymakers made progress towards creating a more equitable Virginia by funding policy priorities that eliminated barriers faced by low-income and communities of color. Now is the time for lawmakers to prove that they care about the health of all Virginians and end the 40-quarters rule for LPRs. The good news is that policymakers have already indicated support for this policy change by allocating $4.5 million (over the biennium) in the General Assembly-approved budget passed in March. While the economic outlook is much different now, lawmakers must continue to prioritize the health of Virginians and restore funding to critical health care budget items that reduce existing health disparities.
Restore funding to extend postpartum coverage for FAMIS MOMS
The postpartum period is an important, but often neglected element of maternity care. New mothers may be dealing with a host of medical conditions, such as complications from childbirth, pain, depression or anxiety–all while caring for a newborn. While Medicaid pays for nearly half of all births and must cover pregnant women through 60 days postpartum, after that period, states can and have made very different choices regarding whether eligibility for Medicaid coverage is continued.
In Virginia, FAMIS MOMS covers pregnant women through 60 days postpartum whose income exceeds the Medicaid threshold (138% FPL) but under 205% of the federal poverty level. That’s $53,710 a year for a family of four. Data from the Virginia Maternal Mortality Review Team show the majority of pregnancy-associated deaths occur more than 43 days after pregnancy. Virginia’s current Medicaid–FAMIS MOMS plan only provides health coverage for the first 60 days after delivery, which is insufficient given that the majority of pregnancy-related deaths occur more than 43 days postpartum.
The previously approved budget included $3.2 million (over the biennium) to extend health coverage for FAMIS MOMS from 60 days to 12 months postpartum. This policy change would allow 1,200 women per year, an additional 10 months of health insurance coverage that would enable them to seek care for serious health conditions that may otherwise go untreated due a break or loss of health insurance coverage. Access to care is critical now and funding should be restored to support this policy priority.
The good news is that the House of Delegates allowed its members to submit amendments to the proposed budget last week. We are incredibly thankful to Delegate Willett and Delegate Sickles for submitting budget amendments that extends postpartum Medicaid coverage for up to 12 months.
***UPDATE*** 1/6/15 Sign on letter for organizations supporting extension of funding for FAMIS
FAMIS, the public health insurance program for low-income families, along with Medicaid, has helped reduce the number of uninsured children in Virginia by 24% from 2008 to 2013. Comprehensive, child-centered benefits and affordable cost-sharing with families make FAMIS an effective means of ensuring that children in low-income, working families grow up getting the preventive and primary health care they need to thrive. Both Republicans and Democrats have championed this public health success for kids in Virginia.
Without action by Congress, however, funding for the entire Children’s Health Insurance Program (which we call FAMIS in Virginia), will expire at the end of September 2015. If this happens, it will be left up to each state to take over the entire cost of insuring these children (the federal government currently covers 67% of the cost) or discontinue the program, leaving an estimated 104,000 Virginia children without insurance. It is unlikely Virginia would take over full financing of the program, as the federal assistance is built into the FY15-FY16 state budget, and the Commonwealth already faces a deficit.
Loss of the FAMIS program would essentially double the number of uninsured children in the Commonwealth. According to a new report released today by the Georgetown University Center for Children and Families, “Children’s Coverage at A Crossroads: Progress Slows,” 5.4% of the Commonwealth’s children, or more than 101,000 kids, remain uninsured.
“Without a renewed commitment to children’s health coverage, we are concerned that the progress we’ve made for children will stall,” said Joan Alker, executive director of the Georgetown University Center for Children and Families. You can listen to a Virginia News Connection story about the report here.
In Virginia, Gov. Terry McAuliffe has already taken action to increase outreach efforts to low-income families throughout the state. As part of his September 2014 Healthy Virginia report, Gov. McAuliffe announced additional funding to reach families who may be eligible for FAMIS but are not aware of the program, or who need help applying. According to the Department of Medical Assistance Services, this outreach has already begun in Southwest Virginia, an important area to target since 22% of the uninsured kids in Virginia live in rural areas.
As a member of the Healthcare for All Virginians (HAV) Coalition, we were disappointed that the General Assembly once again failed to close the health insurance coverage gap for low-income adults during the special session last week. We think it’s important for policymakers and child advocates to understand the great extent to which this decision affects kids. We’ve prepared a Fact Sheet to explain this, and here are a few of the major points: 100,000 parents in Virginia fall in the coverage gap.
400,000 low-income adults fall in the coverage gap in Virginia, meaning they make too much to qualify for Medicaid but not enough to afford health insurance on the federal exchange. Fully one-quarter of those adults are parents of kids younger than 18.
Insured parents get health insurance and health care for their kids.
When parents have health insurance, they are more likely to obtain health insurance for their kids AND take them to the doctor for preventive care and treatment when they’re sick. When parents have access to health care, they are better able to care for their children.
Parents are better able to care for their children when their own health needs are being met — for example, untreated maternal depression has a negative effect on the emotional development of young kids. Also, parents with health insurance are less vulnerable to the potentially exorbitant costs and heavy emotional toll of unexpected medical bills.
For these reasons, Voices for Virginia’s Children will continue to advocate that Virginia close the coverage gap for low-income adults. Contact Voices’ policy analyst Ashley Everette at firstname.lastname@example.org for more info.
For more facts about the importance of closing the coverage gap to improve the health and well-being of Virginia’s kids, see our Fact Sheet.
For the past few years in our child welfare work, we’ve been focused on a longer-term plan to bring “better best practices” to two policy areas: issues faced by older youth in foster care and the use of kinship care in both informal and formal capacities. During this year’s General Assembly session, Voices–along with our child welfare advocacy partners FACES of Virginia Families and the Virginia Poverty Law Center–has asked legislators to introduce legislation in both of these areas. We’ll be actively advocating on these specific bills and budget items, and also lending our voice in support of some additional measures put forth this year by others.
Older Youth in Foster Care & Youth Who Have “Aged Out” of Care:
Since 2008, more than 4350 youth have “aged out” of Virginia’s foster care system, meaning they have turned 18 while still in care and without having been connected to permanent families through adoption, returning home to parents, or having custody transferred to a relative. Young people who “age out” of foster care face considerable risks and challenges, more so than most of their peers not in care, including increased risks of: homelessness, unemployment, school drop-out, health problems, and involvement in the criminal justice system.
In an effort to reduce these risks and offer these young people more support during this critical transition from youth to adulthood, Voices brought a policy initiative to the McDonnell administration that would expand foster care services to youth who have “aged out” of care up to age 21, to include increased support for housing and case management, among other benefits. Governor McDonnell included our recommendations in his outgoing budget, which now exists as the budget bill for this year’s legislative session (SB 30 & HB 30).
Voices, along with our advocacy partners, will be working to preserve this funding in the budget, and will also be supporting a companion bill introduced by Senator Favola, SB 277, which directs the Virginia Department of Social Services to opt in to this “extension of foster care services to age 21” and provide quarterly progress reports to the General Assembly on this effort.
This new program will also extend adoption assistance benefits to youth who are adopted out of foster care at age 16 or older, which will also keep an important focus on older-youth adoptions and increase the number of foster youth connected with families.
Medicaid Eligibility for Youth “Aging Out” of Foster Care
Del. McClellan and Del. Peace (Item 301 #6h), as well as Sen. Howell (Item 301 #18s), put in budget language at our request that would allow Medicaid eligibility for youth who aged out of foster care in another state, but now reside in Virginia. This effort would mirror the Affordable Care Act mandate that provides such eligibility for all foster youth living in the Commonwealth who age out of our own foster care system. By closing this loophole, Virginia would stand at the forefront of providing critical protections for these vulnerable youth, recognizing this population is often very mobile, living without safe, consistent housing, and lacking family connections that would entitle them to coverage under a parent’s private insurance.
We’re also working on SB 284, which would direct the Virginia Department of Social Services to establish regulations around the practice of “kinship diversion.” Through “diversion,” children move in with relatives and “fictive kin” after social workers determine they cannot safely remain with their parents. Social workers facilitate these informal placements, working with the parent and kinship caregiver.
Problems can arise because no court oversees these physical custody transfers, and neither the parent nor the child is appointed an attorney for advice. In some cases, children remain with relatives for years; parents may have little or no knowledge of how to get their children home and there is no requirement that a plan be developed to attempt to reunite the children with their parents. Relatives caring for these children have little or no access to the financial support and services that licensed relative foster parents receive and usually lack information about how to access services for the child.
We believe that regulations will help to support best practices for kinship diversion, and ensure those best practices are used throughout the state.
This bill provides an additional layer of protection for licensed kinship foster families who have relative children placed with them by ensuring that before relative children are removed from the kinship home for non-safety reasons, either a family partnership meeting or a judicial review of the placement change must occur first, to ensure that removing the child is truly in his or her best interests. We know that using kinship care is best practice in child welfare, and aim to provide a bit more stability to its use through this effort.
We’ll keep you updated on these and other child welfare-related bills this session! And please let us know if you have any questions or feedback–email Senior Policy Attorney Amy Woolard at email@example.com.
Virginia is facing an important choice that affects the well-being of many families and children. Under the Affordable Care Act, Virginia has the opportunity to expand its Medicaid program to provide health insurance to adults making below 138% of the federal poverty level (that’s less than $33,000 for a family of four). Virginia has not yet chosen to expand Medicaid.
The General Assembly established a commission to weigh the pros and cons and decide whether Virginia should expand Medicaid. That commission — the Medicaid Innovation and Reform Commission — is seeking public comment.
You have a very important opportunity to weigh in on improving the health of Virginia families! There are 400,000 adults with very low incomes in Virginia who would be eligible for Medicaid if Virginia chooses to expand.
As child advocates, why do we care?Because 25% of those eligible grown-ups are PARENTS of children under the age of 18. In other words, expanding Medicaid provides health insurance to 100,000 VIRGINIA PARENTS!
Research shows that when parents have health insurance, they are more likely to enroll their kids in health insurance and take them to the doctor. That means more kids getting well-child check-ups, staying healthier, and whole families staying out of the emergency room when they get sick! Not only does that mean better health, but smarter spending of healthcare dollars.
So what can you do?
Provide public comment to the Medicaid Innovation and Reform Commission (MIRC), the group of legislators deciding whether we will expand Medicaid in Virginia. The deadline to submit comments: Wednesday, October 16, 2013 before 5:00PM. Let them know that expanding Medicaid helps improve the health of whole families in Virginia, including the kids of approximately 100,000 grown-ups. Every comment counts, and we need to make sure they know we are standing up for Virginia’s children and families.
Here are some points you might want to make. Please personalize your comments.
I know someone personally who does not have health insurance, expanding Medicaid is important to me.
All Virginians deserve access to healthcare- expand Medicaid now!
Medicaid expansion bridges the coverage gap, ensuring that 400,000 Virginians have access to high quality affordable healthcare
The expansion will create 30,000 new healthcare jobs
Medicaid expansion will be 100% federally funded for the first 3 years and then 90% funded by the federal government starting in 2020
Access to insurance improves financial health for families and individuals.
In the past year, four in ten adults with serious mental illness went without mental healthcare, in large part due to having no insurance.
Six in ten adults living with a less serious mental health condition–
but still a diagnosable condition requiring treatment–also went without any mental health care in the past year.
This past Saturday was a busy day in Richmond with both the House and Senate tying up all of the loose ends of the 2013 Session and wanting to adjourn on time. Not to get lost in all of the last minute shuffling, we want to acknowledge and celebrate the many good things included in the budget conference report reflecting Voices’ priority issues. As advocates, you all played a tremendous role in these successes. The conference budget, now approved by the General Assembly, goes to the Governor.
Your tremendous outpouring of support for early intervention (Part C) services for babies and toddlers helped to secure $2.3 million in funding in the current fiscal year and $6 million to meet the shortfall next fiscal year. We are very thankful that the conferees agreed to support the Senate’s request of an additional $3 million on top of the Governor’s proposal of $3 million. Although there will still be a small shortfall, the additional funding will put programs in a much better position for next year. Item 315 #1c
Children’s Mental Health
The conference budget included an additional $1.9 million in FY14 for children’s crisis response services and child psychiatry (Item 315 #4c). This total includes the $1 million added by the Governor and the $900,000 approved by the General Assembly. This amount is in addition to the $1.75 million included in the FY14 budget during the 2012 session that will continue to be awarded to the three regions currently funded, bringing the statewide total to $3.65 million.
The conference budget also includes funding for two training and awareness programs recommended by the Governor’s School Safety Task Force:
Mental Health First Aid received $600,000 in FY14 (Item 315 #2c). Mental Health First Aid (MHFA) is a 12-hour interactive course that teaches the risk factors and warning signs and symptoms of mental health disorders to clergy, teachers, health professionals, and others.
Suicide prevention efforts received $500,000 in FY14 (Item 314 #3c). Funds will go to DBHDS to collaborate with several other state agencies for a comprehensive suicide prevention plan.
Foster Care/Child Welfare
The conference budget provided funding to implement Voices’ bills on independent living, House Bill 1743/Senate Bill 863. These bills allow youth coming out of the Department of Juvenile Justice between ages 18-21 who were former foster youth to get assistance in independent living skills. The funding is combined from CSA funds of $97,614 (Item 283 #1c) and DSS funds of $19,945 (Item 338 #1c) in FY14.
After lots of last minute twists and turns, Virginia now has a path forward to extend Medicaid to the 400,000 low-income Virginians who would be eligible for Medicaid coverage under the Affordable Care Act. The conference budget includes language allowing Virginia to move forward if DMAS adopts certain reforms, and gains federal approval of other reforms (Item 307 #20c). The budget creates a new commission, the Medicaid Innovation and Reform Commission, with the authority to determine whether enough reform has been done to start the eligibility expansion. The House has named its members to the Commission: Dels. R. Steven Landes, R-Augusta, Jimmie Massie, R-Henrico, John M. O’Bannon III, R-Henrico, Johnny S. Joannou, D-Portsmouth, and Beverly J. Sherwood, R-Frederick. The Senate has not yet named its members.
There is some good news from the General Assembly this week on extending Medicaid to low-income Virginians, but we have much work left to do. Voices is a member of the HAV Coalition (Healthcare for All Virginians), which consists of more than 60 organizations working to extend Medicaid. Special thanks to Jill Hanken, of the Virginia Poverty Law Center, for her excellent leadership on this effort.
Voices supports extending Medicaid because fully 25% of the estimated 400,000 Virginians who would be eligible for the extension are PARENTS of children under 18. The extension would make Medicaid available for adults up to 138% of the federal poverty level, which is roughly $32,000/year for a family of four. Research shows that when parents are insured, they are more likely to insure their children and take them to the doctor. Extending Medicaid means improving the health of an estimated 100,000 Virginia families with children.
Yesterday, the House of Delegates and the Senate debated and adopted their amended versions of Virginia’s budget.
The House budget (Item 307 #11h) requires a long list of reforms be completed before extending Medicaid and does not allow extension until July 1, 2014 at the earliest. It would likely take much longer to complete the extensive list of reforms, so in essence, this version delays extension indefinitely. In the debate in the House yesterday, Del. Hope asked questions and raised concerns about this long list of reform contingencies. Please thank him for his efforts. The House amendment on Medicaid was adopted on a divided vote. (69-27).
The Senate budget (Item 307 #18s) was amended during debate on the Senate floor yesterday to allow Medicaid extension to take place once Virginia has gotten approval from reforms from the federal government, meaning extension can happen much sooner. The Senate budget also establishes a special trust fund to capture savings from the various reforms and from the extension itself to cover future costs. This is a CHANGE from their position last Sunday and is much improved. This amendment was adopted by a strong, bipartisan voice vote (there is no formal record of the votes).
Senator Stosch, Chairman of the Senate Finance Committee, presented and supported the new budget amendment, which was also strongly supported by Senator Hanger, the chair of the Health and Human Resources Subcommittee of Senate Finance. In addition, Senators Howell, Favola, Wagner, Edwards, Northam, Barker, and Marsh spoke in support of the amendment. We need to THANK everyone!
These differences will be resolved in the budget conference negotiations. Conferees will be appointed by Feb. 13th, and the budget conference report is due out by Feb. 21st.