Virginia lawmakers voted to expand Medicaid coverage to low income Virginians under the Affordable Care Act. It also includes a trio of amendments committee members proposed to prevent any state funding of abortions and to give big pay hikes to state troopers, who got one previous year, and general district court clerks.
Hanger already has given senators copies of a substitute budget he negotiated with House Appropriations Committee Chairman Chris Jones, R-Suffolk, more than a week ago.
The House of Delegates voted on Wednesday evening in favor of the new budget with a lopsided 67-31 final tally. Several studies have found that Medicaid expansion has led to increased access and affordability of healthcare.
Ultimately, a small cadre of pro-expansion Republicans teamed up with Senate Democrats to bring budget amendments directly to the floor that included expansion and had enough support to pass.
Democratic Gov. Ralph Northam is expected to sign the budget in coming days, and the roughly 400,000 newly eligible low-income Virginias will begin enrolling in Medicaid at the start of next year.
"Let's put the excuses aside".
Health care advocacy groups praised the move and said low income Virginians who can not afford health care coverage will finally receive access to care without jeopardizing their financial future.
In an odd twist, it was the Virginia Senate - traditionally the more moderate chamber and the one that had backed expansion in previous years with help from two now-retired moderate Republicans - that remained dug in.
The bill now heads to the House of Delegates, who voted for Medicaid expansion earlier this year, to be approved.
"Today a bipartisan group of leaders in the Virginia Senate voted to make history and make people's lives better", Northam wrote.
"Just to be certain, I'm leaving", he said with a chuckle.
"It is a ticking time bomb", said GOP Sen. Republicans had previously blocked past expansion efforts, saying the long-term costs were unsustainable.
But Virginia GOP Speaker Kirk Cox said the Trump administration's openness to conservative reforms, including work requirements, "was probably the biggest key" in getting Republican support for Medicaid expansion this year.
The Affordable Care Act calls for the program's benefits to be available to anyone earning up to 133 percent of the federal poverty level, or about $16,000 for a single person.
Wednesday's voting marked the end of a more than four-year battle over whether Virginia should expand the publicly funded health care program for the poor. Democratic Gov. Ralph Northam has signaled he will sign the bill, making the state the 33rd to expand Medicaid under the ACA. And White House officials, including budget director Mick Mulvaney, have urged Virginia lawmakers this year not to expand Medicaid.
The expansion of the government health insurance program was strongly opposed by the Trump administration, which has sought to repeal Obamacare outright.
Hospitals would pay the proposed provider assessments in taxes on revenues, but it would result in a net benefit of nearly $880 million over two years for private acute care hospitals, according to Finance Committee staff members.