Author: Becky Bowers-Lanier
On Sunday, February 18th, the House and the Senate both released their 2018-2020 biennium budgets. The budgets varied drastically by more than $600M dollars, the biggest difference being the inclusion of Medicaid expansion in the House but not the Senate. The fiscal difference between the budgets may create a challenge during budget conference.
The House budget includes Medicaid expansion and several of the Governor’s proposed budget items. The budget expands Medicaid in a two part process. First, DMAS is charged to amend the State Plan for Medical Assistance to expand eligibility and draw down federal funding. Second, the proposed budget requires the state to apply for an 1115 waiver with CMS to implement a work requirement 180 days after the passage of the budget.
The Senate budget does not expand Medicaid and cuts over $400M proposed funding from the Governor’s budget. The Senate budget proposes expanding coverage for people with Severe Mental Illness (SMI), Substance Use Disorder and complex medical conditions. The budget also moves the waiver population into managed care, funds the priority one waiting list and provides screening for Adverse Childhood Experiences (ACEs) in the FAMIS population. While well intentioned, the Senate budget does not mention how these priorities would be funded and does not draw down federal funding at the same rate the House budget proposes.
Next Steps for the Budget Bill Process
Next, the budgets will be debated on Thursday February 22nd. Traditionally, the House and Senate both adopt their own budgets and then reject the other body’s budget. By February 28th both bodies will act on their respective budgets and appoint members for budget conference. The Senate conferees from last year are: Hanger, Norment, Ruff, Newman, Saslaw and Howell. In the House, the conferees from last year are: Jones, Landes and Torian. There are three vacancies for House conferees. The final budget will be presented 48 hours prior to adjournment.
Funding for K12
Without a doubt, the House version of the budget is FAR preferable to the Senate version. Because the House has written in Medicaid expansion (as did the Governor in his introduced budget), there are over $400 million in funds available that otherwise would have been spent on health care. That means the following (and for a more detailed analysis, consult The Commonwealth Institute’s Budget Side by Side (Governor, House Appropriations, and Senate Finance Committees).
- Full re-benchmarking funding for K12;
- State share of salary increases of 2% for school positions effective July 1, 2019;
- Increases the lottery proceeds per pupil allocation; and
- Proposed salary increases for state and state-supported local employees.
The Senate Finance Committee budget amendments do not provide for salary increases for school employees but do provide for increased at-risk add-on funding increases and support for teacher residency partnerships. The VEA will be putting out a call to action in the next day or so, so be on the lookout for it.
Clearly the House budget is more generous for K12 because of the funds saved by expanding Medicaid and being able to draw down federal funds to provide health care access for uninsured Virginians. Read on and take action to thank your delegate and encourage your senator to do the right thing.
Opportunities for Action for Medicaid expansion
- Thank House leadership and Delegates for inclusion of coverage expansion. Email your Delegate and ask him/her to vote yes on the House Appropriations Budget Amendments.
- Tell Senator members to invest in Virginia to provide healthcare coverage to 400,000 Virginians and fund public education and public safety priorities! Email your state senator and ask him/her to reject the Senate Finance Committee’s budget that fails to provide health care access to 400,000 uninsured Virginians.