Medicaid work requirement part of discussions in debate about expansion

Todd Gilbert

Under a narrow Republican majority and a new Democratic governor, Republicans and Democrats have been inching toward a possible compromise that would expand Medicaid in Virginia, while adding changes to the program that Republicans favor.

During a meeting of the House Rules Committee, three Democrats voted in favor of a Republican-backed proposal to apply for a waiver that would add work requirements to the state’s Medicaid program.

Speaker M. Kirkland Cox signaled in a letter to Gov. Ralph Northam that he would be willing to discuss Medicaid expansion but that it wouldn’t pass the Republican-controlled legislature without provisions like the work requirement.

But it’s unclear whether the two sides will be able to reach a compromise, or how far apart they are from reaching a deal.

Del. C. Todd Gilbert, R-Woodstock, who voted to apply for the waiver, described the work requirement letter as a way of gauging whether Northam and Democrats in the legislature are willing to compromise in order to expand the program.

“Our caucus has taken a firm position against the Terry McAuliffe-style expansion that was proposed for the last four years,” Gilbert said. “Any dialogue that the speaker was trying to have was intended…to see if the governor is drawing his own hard line against any type of reform to what is arguably a failing program.”

That could indicate that Republican and Democratic lawmakers are still far apart from reaching a deal that would expand the Medicaid program.

Gilbert said that he was in favor of a work requirement to the Medicaid program, saying that it would help to make able-bodied people become “self-sufficient.” The work requirement would not apply to children or to people with disabilities.

“We’re not trying to make kids or disabled people go out and get a job, we’re just saying that if you’re an able-bodied adult, that you should be either working or pursuing work,” Gilbert said. “And we think that’s ultimately in the best interest of the individual, to have the dignity that’s associated with work.”

Lawmakers in other states have moved toward applying for waivers that would allow them to add work requirements to their Medicaid programs following a policy change from the Centers for Medicare and Medicaid Services. On Jan. 11, the Centers for Medicare and Medicaid Services issued support for states that add the work provisions.

As of Jan. 16, 10 states had submitted proposals to the Centers for Medicare and Medicaid Services, according to the Kaiser Family Foundation, a nonpartisan health policy analysis organization.

Even with a work requirement, Gilbert said that he would vote  against expanding Medicaid. Like many Republicans, Gilbert is concerned about the financial impact that could come from expanding Medicaid.

“I will not be voting for an expansion of the Medicaid program in any form, under any circumstances,” Gilbert said.

Dels. Michael Webert, R-Marshall, Wendy Gooditis, D-Boyce, and Chris Collins, D-Winchester, have not responded to requests for comment. Sens. Mark Obenshain, R-Harrisonburg, and Jill Vogel, R-Upperville, have not responded to requests for comment.

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