Lawmakers In Virginia May Pass An ACA Medicaid Expansion This Year : Shots - Health News Medicaid expansion is a real possibility in Virginia this year. The matter will be taken up in a special session after lawmakers failed to agree on whether or not to do it in the regular session.
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Virginia Republicans Divided On Medicaid Expansion

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Virginia Republicans Divided On Medicaid Expansion

Virginia Republicans Divided On Medicaid Expansion

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ARI SHAPIRO, HOST:

Virginia is one of 18 states that have not expanded Medicaid under the Affordable Care Act. The previous governor tried several times without success. This time the effort has more supporters, and that has created tension among Virginia Republicans. The debate has driven the legislative session into overtime. Megan Pauly of member station WCVE reports.

MEGAN PAULY, BYLINE: By the time the regular session adjourned last week, members of Virginia's GOP-controlled House of Delegates and Senate could not reconcile differences of opinion on Medicaid expansion.

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BARRY KNIGHT: That of course is the 800-pound gorilla in the room, if you will.

PAULY: That's Republican Delegate Barry Knight from the Virginia Beach area. He's one of over a dozen Republicans who voted to include Medicaid expansion in the House budget along with a work requirement this year. It's a big shift in the House position on the issue and comes after 15 seats flipped in the so-called blue wave of last November's election, which also saw the election of Democratic Governor Ralph Northam.

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RALPH NORTHAM: Hello, Virginia.

PAULY: Here he is during a recent rally outside the state capitol in Richmond.

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NORTHAM: Ready to expand coverage?

UNIDENTIFIED CROWD: Yeah.

PAULY: A recent poll showed over 80 percent of likely Virginia voters also support expansion. And Northam is selling it hard.

NORTHAM: I think the House heard that message loud and clear. The Senate, I think, still needs to listen a little bit.

PAULY: He's referring to a strong movement against expansion led by Senate Majority Leader Tommy Norment from the Tidewater area. Norment has come out against the House Republicans who want to expand. He reminds them that despite a slim margin, Republicans are still in charge.

TOMMY NORMENT: I do think that the House of Delegates are still waiting for that moment of lucidity and epiphany to realize that their margin is 51 to 49.

PAULY: But President Trump has mobilized Democratic voters, says Bob Holsworth, a former political science professor at Virginia Commonwealth University. He thinks there's a greater chance of expansion this year. It could pass in the Senate because of a potential wildcard, he says. That's Republican Senator Emmett Hanger from rural central Virginia. Hanger has expressed support for some form of Medicaid expansion and has a track record of voting independently, says Holsworth.

BOB HOLSWORTH: Because what Emmett Hanger has said that's very interesting is that if he decides to support some version of Medicaid expansion, he says there are a number of other Republicans who are going to go over with me.

PAULY: And if they don't come up with a budget that includes Medicaid expansion, Governor Northam has a plan B. He says he'll introduce an amendment to add it back into the budget. In the amendment process, the lieutenant governor, Justin Fairfax, gets a vote if the Senate ties.

JUSTIN FAIRFAX: There are so many people that we can help. And we have the means to do it if we expand Medicaid. We just have to have the political will to do it.

PAULY: Legislators officially get back to work April 11. They need to pass a budget by June 30 to prevent a government shutdown. For NPR News, I'm Megan Pauly in Richmond.

SHAPIRO: And this story is part of a reporting partnership with Kaiser Health News.

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