One senator’s vote in a Tuesday committee meeting signaled that Medicaid expansion is poised to pass through the Senate, which has long opposed it.
State Sen. Frank Wagner’s vote didn’t sway a majority of the Senate Finance Committee, but it meant that there are now at least 21 Senate votes in favor of Medicaid expansion. The drama was heightened a few minutes after Wagner, R-Virginia Beach, broke with his party, when Senate Majority Leader Thomas K. “Tommy” Norment Jr., R-James City, blandly asked the committee to reconsider its vote.
Norment’s unusual move alarmed expansion proponents, fearing a last-minute trick to derail a budget deal hammered out by state Sen. Emmett Hanger, R-Mount Solon, and House Appropriations Committee chairman Chris Jones, R-Suffolk.
“They’re playing chess, not checkers,” said state Sen. William Stanley, R-Moneta — an opponent of Medicaid expansion — smiling slightly as he watched the action.
The full Senate will meet at 9 a.m. Wednesday to consider a budget, including amendments from Hanger that will call for Medicaid expansion.
The question up until now has been whether Hanger and the 19 Senate Democrats will have the votes to pass a version of Medicaid expansion through the budget, extending health care coverage to about 300,000 low-income Virginians. The next step will be to forward the bill to the House of Delegates, which has already voted for expansion.
Wagner has opposed Medicaid expansion but last month said he might be persuaded to support a version of it. He’s since been tight-lipped in public about the plans — until his vote Tuesday to support Hanger’s budget deal.
Later Tuesday, Senate Minority Leader Dick Saslaw, D-Fairfax, confirmed that they have the 21 votes they need to pass expansion, saying, “We’ll be OK tomorrow.” There’s a possibility for more supportive votes, he said, but he declined to estimate how many.
Formally, the Senate Finance Committee narrowly rejected Hanger’s budget deal, and with that vote, Medicaid expansion.
But with the support of Hanger and Wagner, there is now a 21-19 split in favor of Medicaid expansion in the state Senate. Hanger will reintroduce his proposal on the Senate floor on Wednesday, proposing his plan as a substitute for the Senate Finance Committee’s budget.
That committee had essentially reaffirmed the budget the full Senate, including Hanger and Wagner, approved by a 21-19 vote in February. That budget did not expand Medicaid.
Moments after the committee’s votes to reject Hanger’s proposal and reaffirm its earlier stance, Norment made his procedural gambit.
To audible gasps in the hearing room, he asked the committee to reconsider its vote rejecting Hanger’s package and rebuffed Hanger’s question about what his intentions were.
“It was a maneuver, I think, intended to prejudice an outcome tomorrow, in that it had been considered twice, reconsidered and was dead, which could have been overridden by a majority vote on the floor I believe,” Hanger said after the committee meeting.
Senators looked confused at first by Norment’s motion, and then the room began to buzz. Several senators fired off parliamentary questions, focused on the status of amendments on the floor if they were reconsidered in committee and rejected a second time.
Sen. George Barker, D-Alexandria, asked if the committee needed first to reconsider its support of the original Senate budget.
Norment sharply said that was not necessary, and pressed again for a vote to reconsider Hanger’s amendments.
Hanger noted that was out of order. Before Norment could press forward, Hanger abruptly adjourned the meeting, banged his gavel and got up — sparking cheers from Medicaid expansion supporters in the audience.
Hanger said two things sold him on the budget compromise with Jones: money toward behavioral health programs and a boost to the state’s cash reserves.
In the initial budget proposals from the House of Delegates, Hanger did not see enough money that is being saved from Medicaid expansion go back into other health care programs. The deal with Jones puts about $192 million of that money toward behavioral health initiatives, which Hanger said he’s “particularly proud of.”
Other key elements of the Hanger-Jones package:
- State funding of $131.4 million for a 3 percent increase for teachers in fiscal year 2020, up from the 2 percent in the House budget, while the Senate budget said any increases would be contingent on revenue-exceeding forecasts.
- A 2 percent increase for state employees in fiscal year 2020, which was not in the Senate budget.
- $330 million for deepening and widening channels in the Port of Virginia.
- A revised forecast for revenue, adding $120 million to the funds the state is expected to collect over the next two years, reflecting recent tax collection trends.
- An increase in rates the state pays hospitals for treating Medicaid patients; the net effect of those increases, plus a new tax on hospitals to cover the state share of Medicaid expansion, will mean a net increase in hospital income of $880 million during the next two years.
“I still don’t like the provider assessments (hospital taxes), and if there’s a way in the future to work away from that if this continues, then I’d like to do that,” Hanger said. “But for now, the entities most impacted — the hospitals themselves — were very much supportive of doing this as a mechanism for leveraging to get the dollars and to minimize the risk for the state from our general fund balance, so that’ll get us started if we can move forward with this, and you know it’s one of those things, sometimes you have to accept things to reach a compromise.”
Ress can be reached by telephone at 757-247-4535