Health Care Reform Takes New Direction in Virginia

Published January 23, 2020

Democrats won control of both the Virginia State Senate and House of Delegates in the November 5th election, with a number of candidates running on a platform of “more affordable health care,” and protection for people with pre-existing conditions.

  Weeks after the election, Gov. Ralph Northam, a Democrat, told his cabinet to suspend negotiations with the Trump administration on phasing in a work requirement for able-bodied Medicaid recipients and to have them pay premiums. 

Redefining Reform

“The Democrats campaigned on radical policies and they won,” said Paul Milde (R-HD 28), who ran on a Medicaid expansion reform platform, but lost in the election. 

“Their leadership is heavily represented by their more liberal wing,” Milde told Health Care News. “The only impediment is their party’s own decision to go slow. Therefore, I expect them to move on a broad array of issues.” 

In the previous legislative session, Republicans held a razor thin majority in both chambers and in a special session in 2018, greed to Medicaid expansion only with a work requirement. Northum agreed to the compromise but weeks after his party’s victory in the election, told his Medicaid director to hold off on the work requirement federal waiver request. “Virginians made it clear they want more access to health care, not less,” Northam said in a statement.

Rapid Expansion

Coverage under the expansion went into effect January 2019 and by October, the program saw an increase in 325,000 participants. 

“Numerous Republican-led efforts to reform the health care system by providing more options and lower costs have been vetoed by Democrat governors in the last six years, which hindered us from making progress,” Del. David A. LaRock, (R-District 33) told Health Care News.

“On the other hand, any Democrat effort to go beyond Medicaid expansion to ‘universal health care’ is going to be very difficult to accomplish due to provider shortages, and other factors. [Democrats] don’t seem to understand the gap between ‘coverage’ and ‘care,” said LaRock.

Milde says he agrees that it will be hard for Democrats to push through radical health insurance changes, like single-payer health. “Ironically, I expect health care not to be their focus,” said Milde. “They have Medicaid expansion. (In other states), the courts have overturned work requirements. So, they will turn to abortion,” said Milde. 

The Virginia General Assembly, convenes January 8 and runs 60 calendar days, with a 30 day extension option.  

Ashley Bateman ([email protected]writes from Alexandria, Virginia.