Va. lawmakers establish panel to work on Medicaid expansion

Concerns from Attorney General Ken Cuccinelli almost derailed the fragile compromise but revisions secured bipartisan support to pass the bill. Democrats hope it will lead to 400,000 uninsured Virginians moving to Medicaid under the federal health law.

Richmond Times-Dispatch: Reforms At 'Front End' Of Medicaid Expansion
Virginia will embark on a series of major reforms to its Medicaid program as a required prelude to extending coverage to as many as 400,000 uninsured Virginians by the middle of next year. The House of Delegates and Senate voted overwhelmingly on Saturday to adopt amendments to the state budget that include the ability to reform and expand the joint federal-state health care program for the poor, subject to certification by a special legislative committee that benchmarks for reforms have been met (Martz, 2/24). 

The Washington Post: Virginia Lawmakers Approve Sweeping Transportation Plan
Democrats also won a pledge from (Gov. Bob) McDonnell on the Affordable Care Act's planned expansion of Medicaid for poor and elderly people. Soon after McDonnell wrote a blistering letter about his reluctance to expand the shared federal and state program because of growing costs, Democratic senators threatened to derail the $3.5 billion transportation measure unless McDonnell agreed, in writing, to honor their compromise on Medicaid. He did, and despite a last-minute challenge Saturday from Attorney General Ken Cuccinelli II, the Medicaid deal held together well enough for the Senate to take up the historic transportation measure a day after the House passed it (Kunkle and Vozzella, 2/23).

The Associated Press: AG's Ruling Circumvented, Session Meltdown Averted
(Virginia) Democrats had demanded some guarantee of Medicaid expansion and used their numerical parity in the Senate, where each party controls 20 seats and 21 votes are required to enact revenue or appropriations bills, to make it stick. Republican leaders in both the House and Senate helped broker a fragile agreement to establish the Medicaid Innovation and Reform Commission. McDonnell gave the panel his conditional approval in a letter to legislators at 7 p.m. Friday (Lewis, 2/23).

Fredricksburg Free Lance-Star: Medicaid Growth Up To Lawmakers
Lawmakers, not the current or next governor, will be in charge of deciding whether Virginia expands Medicaid eligibility. That's thanks to a much-debated amendment to the state budget House and Senate legislators approved on Saturday, their last major act before adjourning from the regular session for the year. The language creates a commission, appointed by the House and Senate money committee chairmen, to review any waivers the federal government grants Virginia as the year goes on. But final authority on the expansion, said Del. Steve Landes, still reverts to the General Assembly. It gives legislators control over whether the expansion proceeds. Without the budget language, Landes said, the governor would have that control (Davis, 2/23).

Norfolk Virginian Pilot: General Assembly Passes Sweeping Roads Legislation
Medicaid discord threatened again to derail things Saturday when an advisory opinion from Attorney General Ken Cuccinelli made the rounds in the morning. ... Cuccinelli opined that the legislature can't delegate its authority on expansion to a "subset of the members of the General Assembly." ... Legislative negotiators and staffers scrambled at midday to revise the Medicaid language in response to Cuccinelli's opinion. ... Although the legislature worked around Cuccinelli's concerns -- his opinions aren't legally binding -- Medicaid expansion is far from guaranteed in Virginia. Minutes after the budget vote, Republican Del. Bob Marshall of Prince William County vowed to pursue litigation on the basis of the constitutional questions that Cuccinelli raised (Walker, 2/24).