S. Chris Jones: Virginia’s path forward on health care reform

2/22/2018

By S. Chris Jones

AS A 16-YEAR MEMBER of the House of Delegates’ Committee on Appropriations, and chairman for the past five, I have seen dozens of state budgets come and go, but I can say confidently that the House budget presented this week is one of the most responsible budget blueprints the committee has ever produced.

A key priority of the House budget is investing in our workforce through education and training through a strategic approach, changing how we fund programs and align them with Virginia’s economic needs.

The budget is balanced, cautious with revenue estimates and consistent with our long-term public policy goals. It targets investments in the core functions of state government, such as K-12 and higher education. Most notably, though, the House is taking a significant step to expand and reform health care for low-income Virginians.

 The House plan would set up a path for Virginia to use federal Medicaid funding to provide private health insurance to low-income Virginians and include long-sought conservative reforms. Virginia will simultaneously pursue additional health care funding and a waiver to reform parts of the Affordable Care Act.

Virginia will use the expanded federal funding to enroll participants in a private insurance plan. Options include a managed-care plan negotiated between an insurer and the state, an individual plan available on the health insurance exchange or employer-sponsored plans. Health savings accounts to encourage personal responsibility — similar to the plan adopted by Vice President Mike Pence when he was governor of Indiana — also would be included.

Our key reforms include a new requirement that abled-bodied individuals on Medicaid enroll in the Training, Education and Employment Opportunity Program. TEEOP is modeled after the waiver approved for Kentucky and represents our vision for educational opportunities and the dignity of work.

For Virginians with incomes between 100 and 138 percent of the federal poverty level, our plan provides access to private health insurance or employer-sponsored health plans through premium assistance. It also includes reasonable and sensible premiums and cost-sharing so that newly eligible individuals are accountable for improving their well-being. Primary care services and wellness checkups are prioritized over emergency room visits, encouraging people to adopt healthy behaviors and bringing down overall health care costs for everybody.

Our plan requires hospitals to pay for the state’s share of the cost of expansion. This responsible step means individual taxpayers will not have to pay more, or risk seeing funds cut from education, in order to increase health care coverage.

My colleagues and I in the House have expressed concerns about the potential effect of expansion and whether the federal government will keep its commitment. We do not pretend that these concerns are going away, and we took proactive steps to address them.

We included a taxpayer safety switch. If the federal funding for this program is reduced below the state commitments, new recipients will be removed from enrollment. We faced a very similar situation with the Children’s Health Insurance Program earlier this year, and while I’m hopeful we will not have to take that kind of action, we will if the federal government fails to meet its obligations.

We also recognize that the current administration is our best chance to secure conservative reforms to control costs and safeguard taxpayers. We are confident that President Donald Trump and Pence will ensure that Virginia is allowed to enact the reforms that make this program work.

The steps we are taking on health care opened up several other important areas of the budget: We are now able to move state health care resources to other areas. Our budget provides a 2 percent pay raise for teachers and fulfills our commitment to return 40 percent of the educational lottery funds to school divisions without requiring a local match or prescribing their use. It also invests more than $150 million in new funding in higher education to increase the number of degrees earned in four key areas: data science and technology, science and engineering, health care and education. We face chronic worker shortages that require these degrees.

The budget also provides $350 million in funding for dredging the Port of Virginia. This includes $20 million for the engineering and planning phase, and a $320 million bond authorization to begin the work.

The House has laid out a blueprint for the Senate. I am proud of the work we have done, and I believe it is the best path for Virginia to follow.