RICHMOND, Va. — Virginia inched closer to expanding Medicaid on Friday when a key Republican signaled public support for the program, a move that comes despite recent warnings against expansion from President Donald Trump’s administration.
Sen. Frank Wagner of Virginia Beach became the latest Virginia GOP lawmaker to support Medicaid expansion after years of opposition. With Wagner on board, a majority of lawmakers in both chambers now support expanding the publicly funded health care program to about 400,000 low-income Virginians.
Wagner said in a statement that he wants to couple expansion with a new tax on hospitals, while using part of the extra money raised to give tax credits to Virginians making $30,000 to $50,000 a year.
“Expand Medicaid and cut taxes on working families? It can be done!” Wagner’s statement said.
Wagner’s statement comes a day after a White House aide publicly urged Virginia Republicans to reject expansion. Brian Blase, a special assistant to the president for health care policy, said on a conference call Thursday that the Trump administration continues to oppose Medicaid expansion.
Blase said federal funding for Medicaid expansion is “likely to be targeted” in future efforts to reduce the federal deficit. White House Office of Management and Budget Director Mick Mulvaney also issued a statement last month in opposition to Virginia expanding Medicaid.
But pro-expansion Republicans in Virginia have not been moved by White House opposition. They say continued opposition to Medicaid expansion is politically untenable after a Democratic wave in Virginia’s 2017 off-year election and the GOP-controlled Congress’ failed attempts to repeal President Barack Obama’s health care law.
Trump’s support for work requirements for Medicaid recipients has also given Republicans in Virginia and elsewhere political cover for supporting expansion.
In Utah, Republicans approved a partial Medicaid expansion last month that still needs federal approval.
A federal-state collaboration originally meant for poor families and severely disabled people, Medicaid has grown to become the largest government health insurance program, now covering 1 in 5 people. Under former President Barack Obama’s health law, states got the option of expanding Medicaid to cover more low-income adults.
Most states expanded Medicaid, but Virginia was one of those that refused, with opponents saying its long-term costs are unsustainable even with federal promises to pay no less than 90 percent of the costs.
Wagner’s flip on the issue means there is a 21-19 majority of lawmakers in support of expansion, which could end a deadlock over the state budget. Lawmakers have been unable to pass a spending plan because of Republican infighting over whether it should include Medicaid expansion.
The GOP-controlled House has already voted in favor of expanding Medicaid, while the Republican-led Senate has so far opposed it. Lawmakers are set to return to the Capitol next week to try again on a proposed budget.
Senate Republicans leaders said Wagner’s defection has not altered their opposition and that the “only route” to getting a spending plan passed is to strip Medicaid expansion from the budget. State government will shut down July 1 if no budget is passed.
In theory, there are enough votes in both chambers to approve Medicaid expansion, but details about how to do so and whether to include a hospital tax could trip things up.
Sen. Emmett Hanger, the only other Republican senator who supports Medicaid expansion, opposes the hospital tax and said he “doesn’t think much” of Wagner’s proposed tax credit. But Hanger said those issues can be negotiated in the coming weeks and having another Republican senator publicly support expansion is an important milestone.
“It solidifies the fact that, yes, we are going to do something,” Hanger said.