RICHMOND — House leaders will roll out their answer on Medicaid Sunday: An extra $81 million or so in subsidies for hospitals worried about pending government cuts and hoping for the billions Medicaid expansion would bring.
The proposal puts some meat on the bones of a House position that hasn't changed much since the start of this session. House leaders still won't accept federal money to expand Medicaid, but they're calling for an increase in Medicaid reimbursement rates – the amount hospitals get paid to treat patients enrolled in the taxpayer-funded health insurance program for the poor.
Gov. Terry McAuliffe has been pushing the General Assembly to expand the program, opening it up to as many as 400,000 new people. The Senate has called for a hybrid approach.
House Republicans have been standing in the way, saying Virginia's Medicaid program is already growing too fast, and is inefficient. They want an audit instead of expansion.
The higher hospital payments are meant to provide a short-term boost, and keep a closer pace to normal inflation, at facilities calling for expansion to help their bottom lines.
It's difficult to say whether this will be enough to placate hospitals. House leaders gave reporters a sneak peak of their budget proposals Friday, but with the understanding that nothing would appear in newspapers until Sunday, and that other sources wouldn't be called for comment until them.
The House budget also includes more money for mental health reforms than former Gov. Bob McDonnell included in his final budget proposal.
House budget writers called for more crisis centers to hold and stabilize troubled patients during emergencies. They called for more long-term psychiatric beds to go along with a new rule meant to ensure there's always a state bed available when someone needs one.
They also included more money for the free health clinics scattered around the state — roughly a 50 percent increase, according to House Appropriations Chairman Chris Jones, R-Suffolk. Jones said these clinics do a great job of stretching and leveraging state dollars, and deserve the increase.
All of this was done without a tax increase or any new fees, Jones and his budget team said. Where'd they find the extra money? That answer won't come until Sunday, when both the House and Senate formally unveil their budget proposals.
"Choices," Jones explained Friday. "I've had to deliver some bad news."
Once the budgets are unveiled and passed by the two chambers, negotiators from both sides will get to the nitty-gritty of deciding which priorities move forward, and what dollar amounts will be attached to them. The Medicaid issue is expected to be the major sticking point in a two-year budget plan that tops $96.8 billion in spending.
One area the two chambers agree on: The General Assembly needs a new office building. The current one has problems with asbestos, fire and safety code issues, failing air handling units, mold and moisture and a leaky roof, according to a 2012 review.
House and Senate budget writers both want the state to borrow up to $300 million to tear down the current building, located next to the state Capitol, and build a new one. A new parking deck and renovations to the Old City Hall Building next door would be included in that pricetag.
Once the interest is added, this would cost Virginia about $430 million over 20 years. The money would be borrowed under a frequently used section of the state constitution that allows the state to borrow money without holding a statewide referendum first to get voter approval.
Fain can be reached by phone at 757-525-1759.