House Republicans Want External Review of State Medicaid System

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VA House GOP calling for more Medicaid reforms before expansion. VA House GOP calling for more Medicaid reforms before expansion.

House Republicans aren’t budging on Medicaid, declaring Monday that expanding the health care program to more low-income Virginians is “not going to happen this year.”

Instead, they want a thorough, external audit of Medicaid to tighten up unnecessary spending and waste before expanding the program even further.

It’s not good news for Governor Terry McAuliffe, who has made Medicaid expansion one of the primary goals of his administration. He says it all comes down to numbers.

Under the Affordable Care Act, the federal government will cover all of the costs of expansion for the first three years, before incrementally dropping down to 90 percent. Estimates from the Department of Medical Assistance Services suggest that will bring more than a billion dollars to Virginia by 2022.

But Republicans, dismayed by the rocky rollout of Obamacare and a cash-strapped federal government, are skeptical Washington will keep its financial promises.

“I’d say, OK, I want to do a credit analysis of that guarantee,” said 72nd District Delegate Jimmie Massie (R). “In any context, other than the federal government, showed me that balance sheet and that income statement, you know I’d throw you out the window.”

Now Republicans want a full external audit of Virginia’s Medicaid system - something they say has never been done. Citing a national study, they say as much as 30 percent of Medicaid spending is wasted on unnecessary services. The audit would build on other reforms suggested and implemented by Virginia’s Medicaid Innovation and Reform Commission (MIRC), the body responsible for deciding whether the state moves forward with expansion. But Democrats believe this is just another ploy to delay that decision.

In a statement, Governor McAuliffe said Monday:

"We cannot...afford to use an ongoing audit as the latest excuse to deny 400,000 Virginians access to quality medical and mental health care, to leave billions of dollars in federal funding on the table and deny taxpayers the savings that we would reap if we move forward immediately. Running an efficient and cost-effective program is key, but so is taking action to expand access to Virginia families, create jobs and reduce the cost of care.”

“We realize there are a lot of Virginians who need some help,” Massie said. “So we’re not saying that we don’t want to help those people. We’re just saying that this is a big decision that we need to take our time with.”

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