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Source: The Roanoke Times, Va.儲存Dec. 18--The General Assembly will begin its 2014 session without a plan to expand eligibility for Medicaid and obtain federal funds that would cover the full cost of expanded coverage for the first three years.A legislative commission set up to serve as a gatekeeper on the issue held its final meeting of the year Tuesday without making any recommendations for legislative action. The panel has been monitoring state-level reforms to Medicaid services and has heard lengthy presentations about the economic and health care impacts of expanding eligibility for coverage. But, like the legislature itself, the commission is divided over how the state should proceed.The panel's chairman, Sen. Emmett Hanger, R-Augusta County, said the commission will continue its work in January. Hanger said he remains hopeful that lawmakers can reach a compromise that would allow Virginia to draw down more than $2 billion a year in federal funding through 2016 while implementing reforms that reduce costs and improve service.Under the Affordable Care Act, the federal government would pay the full cost of the expansion from 2014 to 2016, and then gradually reduce its share to 90 percent by 2020. Nearly 400,000 uninsured Virginians could qualify for coverage if the program, which has stringent eligibility limits, is expanded to serve people with incomes up to 133 percent of the federal poverty level.Republican leaders in the House of Delegates remain opposed to Medicaid expansion, insisting that the federal government can't be trusted to fund its share of the program. Del. Steve Landes, R-Augusta County, the vice chairman of the Medicaid Innovation and Reform Commission, also has argued that some of the state's reforms should be tested before Virginia commits to covering an expanded population.The panel's newest addition, Del. Charles Poindexter, R-Franklin County, voiced similar concerns in an interview Tuesday. Poindexter was appointed to the commission to replace Del. Beverly Sherwood, R-Winchester, who was not re-elected to the House."A lot of people迷你倉are concerned -- I know they are in my district -- about whether the federal government really has the money to pay for this program over time, and whether we're going to be left holding the bag down the road," Poindexter said.A provision in the state budget would allow Virginia to roll back Medicaid eligibility if the federal government retreats from its funding commitments. Poindexter said that would put the General Assembly "in an impossible position.""We shouldn't allow ourselves to be placed in it," Poindexter said. "We should make sure the program works before we ever sign up."Gov. Bob McDonnell, who leaves office next month, has presented lawmakers with a budget plan that would halt any potential Medicaid expansion in 2016 and require the General Assembly to reauthorize it after deciding whether the state can afford to proceed. McDonnell's budget plan also would keep the legislative commission intact for the next two years.Democratic governor-elect Terry McAuliffe supports Medicaid expansion and has called on state business leaders to get behind the effort and help him persuade the legislature. McAuliffe's transition team has not said how the incoming governor will respond to McDonnell's budget proposals.Hanger said delaying a decision on Medicaid expansion will hurt hospitals facing Affordable Care Act reductions in payments for uninsured patients and those that treat a disproportionate share of Medicaid and Medicare patients. Medicaid expansion was intended to mitigate the impact of those cuts.To make matters worse for Virginia's private hospitals, McDonnell's budget proposal would withhold an inflation adjustment in Medicaid payments in the first year of the biennium. That will cost the hospitals more than $34 million in state and federal funds."The trajectory is not a good one for hospitals," said Katharine Webb, senior vice president of the Virginia Hospital and Healthcare Association.Copyright: ___ (c)2013 The Roanoke Times (Roanoke, Va.) Visit The Roanoke Times (Roanoke, Va.) at .roanoke.com Distributed by MCT Information Servicesself storage