Virginia Gov. Ralph Northam (D) signed a two-year $115 billion budget that includes Medicaid expansion Thursday, making the state one of more than 30 that have expanded Medicaid eligibility under the Affordable Care Act (ACA).
The bill will provide health coverage to about 300,000 to 400,000 low-income residents, and many individuals — about 138,000 people fall in the state’s coverage gap — could be insured for the first time.
“It has been a long road to get here, but I couldn’t be happier to sign this budget bill today,” Gov. Northam said during his speech in front of the state Capitol building Thursday afternoon. “I believe in making sure all Virginians have the access to the care that they need to be healthy and productive.”
Amid jubilant cheers from the crowd, Northam added that “it took leadership and courage to get us this far … In the hard-fought negotiations, we came together in good faith and Virginians are better for it.”
Northam praised the efforts of state lawmakers in reaching a “compromise” on the budget bill. While it was hailed as a victory by health care advocates, the legislation also includes a provision that asks the federal government to approve work requirements for newly covered individuals starting in January 2019. The requirements will condition eligibility on 80 hours of reported work after a year of enrollment. Those who do not meet the requirement will be locked out of coverage until the end of the year-long period.
The work requirement provision was a Democratic concession offered to Republicans during the months-long negotiation process between state lawmakers. Progress on the bipartisan bill, which was five years in the making, gained steam after last year’s elections, when voters, galvanized by health care issues, diminished Republican control of the House by almost 23 percent. The GOP now barely maintains control at 51-49. The Republican margin of control in the Senate is just as slim at 21-19. Last week, four Senate Republicans joined all 19 Democrats in voting in favor of the budget legislation.
By expanding Medicaid, Virginia is now eligible for approximately $142 million in federal funding every month. Several other states are also considering Medicaid expansion, including Utah, Nebraska, and Idaho, aiming to take advantage of the ACA’s popular provision that allows for expanding coverage to households earning 138 percent of the federal poverty level.
Amanda Michelle Gomez also contributed to this report.