Del. Tom Rust (R-Herndon) will propose a bill called the Virginia Health Care Independence Act when the House of Delegates convenes next month to discuss Medicaid expansion.
Rust said his legislation is the only Medicaid-related proposal he’s aware of that will be debated during a special two-day session beginning Sept. 18. The primary intent of the bill, he said, is to return to Virginians millions of tax dollars the state sends to Washington.
Republicans and Democrats in the General Assembly went toe-to-toe for the first half of 2014 over expanding Medicaid coverage to as many as 400,000 uninsured Virginians through the federal Affordable Care Act. The heated debate led to talks of a government shutdown because Gov. Terry McAuliffe (D) pledged he would not sign a budget that didn’t include Medicaid expansion through the Affordable Care Act.
Months after the regular legislative session ended, and just a few days before the new fiscal year, Republicans won the fight and forced McAuliffe to break a campaign promise and sign a budget free of expansion.
Rust was the only Republican out of 68 in the 100-member House of Delegates who vocally supported expansion.
The veteran lawmaker who represents portions of Loudoun and Fairfax counties said his proposal, which involves using the new federal funds to incentivize the uninsured to sign up for employer-provided care or purchase private insurance with vouchers, wouldn’t cover the 400,000 figure, but roughly 260,000 people.
“The bill is distinguished from previous proposals by the senate and the governor,” Rust said, “in that it emphasizes comprehensive, systemwide reform of Medicaid and leverages to a much greater degree the strengths of the private sector, including the availability of employer-sponsored insurance, in an effort to minimize the role of Medicaid in improving access to health care for the uninsured.”
Key elements of the Virginia Health Care Independence Act, according to Rust, include providing access to health care in several forms, ranging from “a premium voucher system to purchase private insurance, to an enhanced network of safety net providers.”
The bill would implement a temporary “bridge plan” to provide private insurance coverage to low-income Virginians at or below 133 percent of the poverty level using Affordable Care Act funds, according to Rust, who stressed the preferred form of coverage is employer-sponsored insurance using premium assistance, or vouchers.
Approximately 70 percent of the people who would become eligible for coverage under the proposal are working, Rust said.
The Virginia Health Care Independence Act also aims to allow individuals without access to employer-based insurance to enroll in private Medicaid-managed care plans initially and then transition to coverage through qualified health plans available on the federal health insurance exchange.
“I believe the Virginia Health Care Independence Act employs market-based, conservative principles to reform Medicaid for the long term and improve economic opportunity for low-income working Virginians,” Rust said.
McAuliffe’s office staff said they were aware Rust was drafting a proposal, but haven’t seen a final draft.
Brian Coy, a McAuliffe spokesman, said the governor is open to anything that will expand coverage to Virginians and bring tax dollars back to the commonwealth.