Updated: Wednesday, 20 Feb 2013, 9:18 PM EST
Published : Wednesday, 20 Feb 2013, 8:28 PM EST
RICHMOND, Va. (AP) — Gov. Bob McDonnell warned state legislative negotiators on Wednesday not to expand Medicaid in Virginia without major federal and state cost reductions first.
McDonnell wrote to the legislature's top budget chiefs — Senate Finance Committee chairman Walter A. Stosch and House Appropriations Committee chairman Lacey E. Putney — as they and 10 other negotiators grappled with Medicaid expansion, the largest remaining obstacle to reaching a budget compromise in time for Saturday's final adjournment.
At issue is whether to authorize the McDonnell administration to pursue the expansion of Medicaid to about 400,000 more uninsured Virginians sooner as the Senate wishes, or waiting until 2014 to decide when — if ever — to expand Medicaid, as the House prefers.
"Please understand that I cannot and will not support consideration of an expansion of Medicaid in Virginia until major reforms are authorized and completed, and until we receive guarantees that the federal government's promises to the states can be kept without increasing the immoral national debt," McDonnell wrote. "The country is broke, and I will not support policies that make it worse."
The governor's letter came a day after his administration received conditional approval from the federal Centers for Medicare and Medicaid Services for several reforms McDonnell had sought, including more Medicaid administrative simplicity, more efficient service delivery and payment and benefits more comparable to commercial plans.
The federal agreements, however, were conditional, accompanied by several areas where agency director Cindy Mann said further negotiation and approval are required.
Under the Affordable Care Act championed by President Barack Obama, states have the choice of whether to expand Medicaid, a federal-state program that helps underwrite health costs for the indigent, disabled, elderly, blind and low-income families with children. The federal government said it would pay the full cost of expansion for the first three years and 90 percent of the costs after that.
Medicaid now accounts for slightly more than one-fifth of Virginia's general fund.
"Thus the time is now to dramatically reform the way we deliver medical services in Virginia to mitigate against and possibly reduce such future spending growth," he wrote. "As part of our Medicaid overhaul, we must act now to obtain the approval for the necessary reforms and flexibility from the U.S. Secretary of Health and Human Services."
"We have one chance to do this right," he cautioned.
McDonnell wrote his letter on the same day that Florida's Republican governor, Rick Scott, announced that his state would expand Medicaid coverage to roughly 900,000 more Floridians, a surprise decision from the vocal critic of Obama's health care reforms. So far, seven Republican governors have agreed to expand Medicaid under the overhaul.
Also on Wednesday, Virginia Tea Party Patriots Federation chairman Mark Daugherty warned McDonnell and Virginia's GOP-dominated General Assembly "not be seduced by the lure of federal funds in the short-term to expand Medicaid."
McDonnell's letter: http://www.governor.virginia.gov/utility/docs/20130220144607989.pdf
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