WAYNESBORO — Two Shenandoah Valley legislators have been named to a subcommittee that will hash out the impact the incoming Trump administration will have on the federal Affordable Care Act, better known as Obamacare.
The subcommittee will also examine other health care concerns, including the cost of various programs, at the state level.
Del. Steve Landes, R-Weyers Cave, expects the subcommittee to convene in January. Should the subcommittee continue into 2018 and beyond, he said, funding to operate it would be allocated in future state budgets.
President-elect Donald Trump had promised to repeal the federal health care law during his run for president, but has since backed off a complete revocation. In a post-election interview, Trump said he hopes to retain the pre-existing conditions portion of the law and the stipulation that a young adult could remain on their parents' policy until age 26. Other parts of the plan, he said, might be retained, but much of its should be amended or discarded.
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State Sen. Emmett Hanger, R-Mount Solon, is also expected to serve on the General Assembly subcommittee. He and Landes say Virginia must be ready to react to changes in the federal health care law and understand how those changes could effect services in the commonwealth.
Hanger, the co-chair of the Senate Finance Committee, said one potential change could see federal Medicaid funding offered to states as a block grant, a move Trump has said should be considered. U.S. Speaker of the House Paul Ryan also favors a block grant approach.
"If a block grant happens, much depends on how the block grant is appropriated,'' Hanger said. Now, under Virignia's existing Medicaid program, the state pays 50 percent of the cost for recipients, while the federal government pays the remaining 50 percent.
The two legislators say the subcommittee would also have other priorities. Landes said the group is expected to review a soon-to-be-released study of Virginia's existing Medicaid program. The study, from the Joint Legislative Audit and Review Commission, or JLARC, will be released in December.
Landes, vice chairman of the House Appropriations Committee, hopes the study offers reforms that make the existing Virginia Medicaid program more efficient. Medicaid's increased costs have been one of the major drivers of the Virginia budget in recent years. A recent JLARC report indicated that spending on Medicaid had increased 75 percent in the past decade in Virginia.
Landes has been one of the most outspoken opponents of Medicaid expansion.
That option is available under the Affordable Care Act, including the promise that the federal government would offer 100 percent payment of expansion initially, and 90 percent starting in 2020.
Thus far, the General Assembly has refused to expand Medicaid in Virginia, despite Gov. Terry McAuliffe's request that the commonwealth do so. McAuliffe has said passing up an expansion that could help thousands of low-income Virginians — particularly when such expansion initially won't cost Virginia a dime — is unconscionable. Republicans, though, say the key word there is "initially." They fear Medicaid expansion costs will eventually spiral out of control, leaving the state and its residents much worse off in the long run. Many also don't trust the federal government to come through on its 100 percent reimbursement commitment.
If the Medicaid expansion portion of the Affordable Care Act is repealed, newly covered Medicaid recipients in 31 states and the District of Columbia would no longer have coverage.
Hanger said the subcommittee would also look at other key health care issues, including psychological and psychiatric treatment needs.
"We've got a lot going on with mental health,'' he said. "There are a lot of issues. We need to work in a more coordinated fashion."