RICHMOND, Va. (AP) - General Assembly budget negotiators worked Friday to put the final touches on a possible compromise on Medicaid expansion, the biggest sticking point in adopting revisions to the state's two-year, $88 billion spending plan.
A vote on the revised budget was expected Saturday, the final day of the 46-day General Assembly session. A spokesman for Gov. Bob McDonnell, Tucker Martin, said the governor would not comment until the deal is final.
The Senate and the House of Delegates offered substantially different approaches to Medicaid in conflicting versions of the budget. The Senate favored expanding the program to an additional 400,000 uninsured Virginians just over the poverty level, provided the state finds substantial savings and reforms and the federal government agrees to them. The House budget called for deferring expansion until those reforms are in place.
House Majority Leader Kirk Cox, R-Colonial Heights and a member of the budget conference committee, said a compromise that was in the works Friday would establish a 12-member commission consisting of five senators, five delegates, and - as nonvoting members - the state secretaries of finance and health and human resources. The commission would determine when enough reforms were in place to begin expansion.
"They would be the approval authority," Cox said.
The commission would meet every other month, starting this summer. Cox said details were still being worked out between House and Senate budget negotiators.
Under President Barack Obama's health care overhaul, states have the choice of whether to expand Medicaid, a federal-state program that helps pay for health care for the indigent, disabled, elderly, blind and low-income families with children. The federal government said it would pay the full cost of expansion for the first three years and 90 percent of the costs after that.
The governor sent a letter Wednesday to the lead negotiators admonishing them not to expand Medicaid until major state and federal reforms are achieved.
"Please understand that I cannot and will not support consideration of an expansion of Medicaid in Virginia until major reforms are authorized and completed, and until we receive guarantees that the federal government's promises to the states can be kept without increasing the immoral national debt," McDonnell wrote.
The missive angered Democrats, who favor prompt expansion, and added to the uncertainty of the delicate budget talks.