Kentucky’s Medicaid expansion challenge raises questions for Virginia

Virginia’s plan to expand health-care coverage for more of its poorest residents — requiring some to work for benefits — is still on track despite a similar plan being blocked in Kentucky by a federal judge.

But could the situation in Kentucky mean a future legal challenge of Virginia’s Medicaid work requirements?

Officials say it’s early to tell and that they will stay the course as they prepare to expand Medicaid, estimated to deliver subsidized health care to at least 300,000 additional low-income residents.

Down the road, the federal judge’s decision could mean a win-win situation for Democrats in Virginia, who have long wanted Medicaid expansion without any work requirements. For Republicans, it could mean the loss of a reform that sold them on Medicaid expansion.

Medicaid expansion was part of a bitter, five-year battle in Virginia. This year, lawmakers blew their deadline to pass a state budget by almost three months because of the Medicaid debate.

In order to gain Republican support, Democrats reluctantly agreed to requiring certain Medicaid enrollees either to work or be working toward job skills.

Norment warned his colleagues of the possible implications of expanding Medicaid, down to the minutes before the Senate passed the bill. To him, the legal decision over Kentucky’s plan for work requirements could mean that the financial component — the reimbursement for health care — could be in the air, too. It’s anyone’s guess, he said.

“It really just is a legislative mirage,” Norment said in a recent interview. “The people, the champions of Medicaid expansion, I think, were willing to overreach on any plausible or implausible argument that they could make to get that through.”

But while Bevin cut off vision and dental benefits for up to 460,000 people in Kentucky, that’s not likely to happen in Virginia’s political climate, said Quentin Kidd, director of Christopher Newport University’s Wason Center for Public Policy. That’s not a move that Virginia Gov. Ralph Northam — who campaigned heavily on Medicaid expansion — or even a future Republican governor would have the support for in Virginia, Kidd said.

He thought something else is more likely, based on how the state’s political climate is looking.

“I do think that if Democrats manage to take over the House and/or the Senate in the next round of elections in 2019, it could very well be possible that Democrats simply drop the work requirement from the law,” Kidd said.

It’s early, but it’s important to remember that there are an “awful lot of people in both parties that want this to work,” Farnsworth said. So, there could be last-minute adjustments to the Medicaid plan that will eventually be submitted to the Trump administration.

“Medicaid expansion has had bigger hurdles than this,” Farnsworth said.

Amin can be reached by phone at 757-247-4890.

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