Virginia Republicans are accusing Democratic Gov. Ralph Northam of backtracking on a promise to pursue Medicaid work requirements, which was part of a deal that led Republicans to vote in favor of Medicaid expansion.
With Democrats set to take control of both chambers next month, Northam ordered the Virginia Department of Medical Assistance Services (DMAS) to pause its negotiations with the federal government on work requirement policies until the new leadership is sworn in.
In a letter to the federal Centers for Medicare and Medicaid Services, DMAS Director Karen Kimsey said the state likely will modify its waiver provisions and that the department will restart negotiations when there is a clear policy direction. She said that Virginia is concerned about the potential costs of implementing the work requirements when they will likely be rescinded.
In a statement, House Majority Leader Todd Gilbert, R-Shenandoah, said that Northam broke his promise.
“The agreement Governor Northam reached with Republicans was made in good faith, Gilbert said. “He gave his personal assurance that the long-term policy of the Commonwealth would be Medicaid expansion with a work requirement. Broken promises like this are the reason so many people hate politics.”
Similarly, House Speaker Kirk Cox said in a statement that he was disappointed.
"I’m disappointed to say the least,” Cox said. “The Governor and I made personal commitments to each other on this long-term public policy agreement. There wasn’t an asterisk that said ‘unless my party wins the next election.’ It’s a sad reflection on the value of integrity in modern politics."
Northam said in a statement that his decision to pause the negotiations and his intent to amend the deal is what Virginians want, according to the election results.
“Virginians made it clear they want more access to health care, not less," Northam said. “Given the changed make-up of the General Assembly and based on conversations with new leadership, it is unlikely Virginia will move forward with funding a program that could cause tens of thousands of Virginians to lose health care coverage. Other states that have tried to implement these requirements are also facing legal threats and rising costs. For these reasons, I’ve instructed our Medicaid Director to pause negotiations – I look forward to working with the new legislature to increase access to the high-quality, affordable healthcare Virginians deserve."
More than 300,000 Virginians have enrolled in Medicaid expansion. Because of changes to the funding structure, Medicaid costs the commonwealth less money than it did the previous year, but that will be subsidized by more spending from the federal government.