Medicaid Expansion plan unworkable

HouseGOP2014 General Assembly Session, Export, Health Care, Issues

House Majority Leader Kirk Cox (R-Colonial Heights) spoke on the house floor today about ObamaCare’s Medicaid Expansion.

Leader Cox highlighted the Governor and Senate’s unworkable Medicaid Expansion plan, its reliance on temporary approval from the Obama administration, its reliance on borrowed money from Washington and recent evidence that suggests Washington won’t keep its commitment to pay the bill.

Borrowed Money

The Governor and Senate’s proposed Medicaid expansion plan would rely on billions of dollars in borrowed money. We have said clearly and consistently that we do not think the federal government will be able to keep its indefinite commitment to pay for Medicaid expansion, but this is more than just skepticism.

  • In 2011, President Obama proposed $15 billion in cuts to state Medicaid payments. Healthcare analysts said this proposal would dramatically shift the burden of Medicaid expansion costs to the states.
  • The Obama administration also recently announced cuts to Medicare Advantage, proposing a nearly 2% cut to insurer rates on the important program that serves over 180,000 Virginians.
  • Yesterday, the Department of Defense announced cuts to TRICARE, the health care program for military personnel. The details are not clear, but Secretary of Defense Hagel admitted program participants would “have to pay more.”

Simply put, the federal government is $17 trillion in debt. They do not have the money to meet current obligations, let alone the costs of Medicaid expansion.

Unworkable Plan

The Governor and Senate’s plan is unworkable.

In order to be implemented, the Governor and Senate’s plan would require top-down, federal approval in the form of a temporary waiver from the Department of Health & Human Services.

Every aspect of the proposal would be subject to the terms, conditions and approval of the Obama Administration. Moreover, if this waiver were approved, it would only be a temporary waiver – lasting only until 2017.

While proponents tout flexibility, in reality every aspect of this program would be subject to federal approval.  Virginia cannot turn its healthcare decisions over to the same administration that promised us we could keep our doctors and our health plans.

Key provisions of this plan are also not likely to be approved by the federal government.

The federal government has never approved work-search requirements for Medicaid expansion, and the federal government has limited states’ ability to implement cost sharing, saying cost sharing must not be greater than cost sharing under current Medicaid.


The Governor and Senate’s Medicaid expansion plan is unworkable and unsustainable.  It relies on borrowed money and would require federal approval it isn’t likely to receive.

More importantly, this poorly crafted plan has been wrongly injected into the budget process. Rather than debate Medicaid expansion on its merits, the Governor and Senate have decided to use the budget as a bargaining chip.

This is wrong and irresponsible. Virginia teachers, law enforcement and local governments are counting on the General Assembly to finish its budget work on time next week. The Governor and Senate should stop playing political games and let Virginia pass a clean budget bill.