Northam told reporters Friday that he had informed key lawmakers working on the state budget that agreeing to expand Medicaid and a new tax on hospitals would give them much greater say in how to spend about $350 million in related new funding. Otherwise, he said he has enough votes to expand Medicaid and to spend the associated money on his own terms through a budget amendment.
“If they don’t do Medicaid expansion and pass a budget, then obviously it would give me a lot more control than it would otherwise,” Northam said.
The governor’s comments come at a key moment in the state’s effort to expand Medicaid under former President Barack Obama’s health care law to provide coverage for 300,000 low-income Virginians. After blocking Democratic efforts at expanding Medicaid for years, Republican resistance to the program is now split.
Several House Republicans, including Speaker Kirk Cox, support a Medicaid expansion program that includes work requirements and cost-sharing provisions. The House has included Medicaid expansion in its proposed budget. The Senate budget does not include Medicaid expansion, with most Republican senators saying the state cannot afford the long-term costs.
Expanding Medicaid with a hospital tax gives the House more money to spend in its budget, which includes raises for state workers and teachers. The Senate’s budget is much more Spartan.
Lawmakers are scheduled to adjourn next week but could put that off if they can’t pass a budget. If they do pass one without Medicaid expansion, Northam would have the opportunity to amend it when lawmakers come back for a single-day session in April.
Republicans control the Senate 21-19, but GOP Sen. Emmett Hanger supports Medicaid expansion and Democratic Lt. Gov. Justin Fairfax holds the tiebreaking vote. Hanger has said he won’t support the House budget, in large part because of the proposed hospital tax. But Northam said he believes he can win Hanger’s support on an amendment vote, which along with Fairfax, would give Northam the needed majority.
GOP Sen. Steve Newman said he appreciated the governor’s candor but said Northam has miscalculated his ability to win enough votes in both chambers to get Medicaid expansion passed through an amendment.
“I think he’s being upfront with us, but I just don’t see how that math works,” Newman said.
He also said Northam’s message was an indication he’s concerned the House may drop Medicaid expansion and side with the Senate instead.
“The governor is starting to recognize that the Senate of Virginia is very, very committed to our current position,” Newman said.