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- The Virginia Senate approved a state budget that includes Medicaid expansion under the Affordable Care Act, or Obamacare.
- A final vote in the House is needed, but the move would make Virginia the 33rd state to approve Medicaid expansion.
- The potential is an example of Obamacare’s resiliency despite GOP attempts to repeal the law.
Virginia’s state Senate voted Wednesday in favor of a plan that would expand the state’s Medicaid program under the Affordable Care Act, or Obamacare, in a move that shows the resiliency of the landmark healthcare law.
The Virginia Senate voted 23 to 17 to pass a budget that included Medicaid expansion, which could extend healthcare coverage to roughly 400,000 low-income Virginians.
The House must re-ote on the Senate package, but a similar measure already made it through that chamber and the second vote is expected to follow suit.
The move would make Virginia the 33rd state to approve Medicaid expansion. Washington, DC, also expanded the program, and while Maine citizens voted for expansion in 2017, GOP Gov. Paul LePage has refused to implement it.
The move is the culmination of five years of back-and-forth on Medicaid expansion in the state.
GOP Gov. Bob McDonnell turned down the expansion in 2013. Former Democratic Gov. Terry McAuliffe, who was elected in 2014, attempted multiple times but was ultimately unable to convince the GOP-controlled legislature to approve a expansion measure.
But after devastating electoral losses in 2017 that substantially reduced the Republican majorities in both the House and Senate, a handful of Virginia Republicans came around on the issue. Newly elected Democratic Gov. Ralph Northam added extra pressure when he told legislators that he would not sign a state budget that did not include Medicaid expansion.
While Democrats secured a large victory, the final bill does include a caveat. The bill also institutes a work requirement for the Medicaid program, which compels recipients to work or volunteer for at least 20 hours a month to get benefits. The minimum number of hours a month would steadily increase while the person was on Medicaid before topping out at 80 hours a month after a year.
The Senate-approved plan would also require people making above the federal poverty limit to pay more for out-of-pocket care, another Republican request.
Democrats nearly universally opposed the idea, but it was a requirement for many Republican members to get on board with expansion. In theory, such a provision could be repealed if Democrats gains a firm advantage in the legislature.
The Virginia vote comes at a crucial vote for Medicaid expansion and the broader ACA in general.
In addition to the Commonwealth state, proponents in three other states are attempting to pass measures to expand the program. A ballot measure in Utah will allow voters to decide on the issue, while activists in Idaho and Nebraska are collecting signatures for similar ballot measures in those states. Reclaim Idaho, the group pushing for expansion in that state, said the group received enough signatures to secure a ballot measure.
For the broader ACA, the popularity of the Medicaid expansion underscores the continued resiliency of the law despite the GOP’s attempts to repeal the legislation. In addition, a Kaiser Family Foundation poll in April 2018 found that 49% of American held a favorable view of Obamacare while 43% viewed the law unfavorably.