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FROM CMS FOR SOMETHING WE
REQUESTED LAST YEAR?
>> I WOULD SAY TO THE GENTLEMAN,
IT WASN'T A WAIVER, BUT IT
REQUIRED FEDERAL APPROVAL AND WE
ARE STILL WAITING AND I DO NOT
KNOW THAT THAT WAS REALLY AN
EXTRAORDINARY REQUEST.
>> I THANK YOU.
>> THE GENTLEMAN FROM ROANOKE
CITY, MR. RASOUL.
>> SPEAKING TO THE AMENDMENT.
>> THE GENTLEMAN HAS A FLOOR.
>> THANK YOU, MR. SPEAKER.
LADIES AND GENTLEMEN OF THE
HOUSE, WHAT IT WOULD BE WITHOUT
A CHART TODAY?
I KNOW YOU HEARD ABOUT THE
BILLION DOLLARS IN REPORTED
SAVINGS THE COMMONWEALTH WOULD
REALIZE WITH MEDICAID EXPANSION.
AS A NEW MEMBER OF THE HOUSE, I
WANTED TO MAKE SURE PEOPLE
DIDN'T SAY YOU GUYS RECRUITED ME
JUST FOR MY BASKETBALL SKILLS.
SO I SET OUT TO HERN A LITTLE
MORE -- LEARN A LITTLE BIT MORE
ABOUT THIS BILLION DOLLARS AND I
FOUND OUT THE LARGEST PART IS IN
INDIGENT CARE AND I LEARNED THAT
INDIGENT CARE IN OUR BUDGET IS
LARGELY RELATED TO A SPECIFIC
LINE, ITEM 301-B, WHICH IS PAID
ONLY TO UVA AND VCU FOR INDIG
GENT CARE.
I DECIDED TO TRY TO UNDERSTAND
THIS SPECIFIC CALCULATION AND
THERE ARE THREE MAJOR STEPS.
FIRST, CALCULATE INDIGENT CARE,
WHICH THEY COME TO $3 BILLION
BETWEEN FISCAL YEAR 2015 AND
2022.
CALCULATING IT WITH 7%
HEALTHCARE INFLATION.
NEXT, STEP TWO, RECALCULATE I
INDIGENT CARE THAT WOULD QUALIFY
UNDER EXPANSION, WHICH IS ABOUT
73% OF TOTAL INDIGENT CARE AT
ABOUT $2.2 BILLION AND STEP
THEE, CALCULATE THE SAVINGS,
WHICH THEY CALCULATED AT 50%,
ABOUT $1.1 BILLION WHERE THE
FEDERAL GOVERNMENT PAYS THE
OTHER 50%.
WELL, MY FRIEND, DELEGATE BUDDY
FOWLER, SAID SOMETHING JUST
DON'T SMELL RIGHT.
SO I APPLIED THE SNIFF TEST
CALCULATION BELOW, USING VERY
CONSERVATIVE FIGURES.
I ASSUMED ZERO PERCENT INFLATION
IN HEALTHCARE COSTS, AND THAT
THE COMMONWEALTH WOULD ONLY PAY
40% OF THE COST INSTEAD OF THE
FULL 50%.
AND IN CASE WE EXPERIENCE HARD
TIMES IN THE COMING YEARS.
THIS, EVEN THOUGH IN 2016, WE'LL
BE PAYING 47%.
THE RESULT IS STILL A SAVINGS OF
$725 MILLION OR OVER $90 MILLION
PER YEAR OVER THE NEXT EIGHT
YEARS.
I HUMBLY REQUEST YOU CONSIDER
THESE REAL SAVINGS TO ITEM 301-B
AS YOU FORMULATE YOUR OPINION ON
HOW VIRGINIA SHOULD MOVE
FORWARD.
>> THE GENTLEMAN FROM AUGUSTA,
MR. LANDES.
>> MR. SPEAKER, I THINK SPEAKING
TO ITEM 4-14.00 NUMBER 3-H, NOT
ITEM 301-B, MR. SPEAKER AND
LADIES AND GENTLEMEN OF THE
HOUSE, THE GENTLEMAN FROM
SUFFOLK MENTIONED A COUPLE
RELEVANT FACTS, I THINK, I JUST
WANT TO REITERATE.
AND ALSO ADDRESS IN ADDITION TO
THE QUESTIONS THAT THE GENTLEMAN
FROM HENRICO ASKED.
FIRST OF ALL, RELATED TO THE
GENTLEMAN THAT JUST PREVIOUSLY
SPOKE, THE DISH PAYMENTS FOR
HOSPITALS DO NOT TAKE EFFECT
FROM THE STANDPOINT OF LOSING
THAT ABILITY UNTIL 2016.
SO THAT IS SOMETHING I THINK
PEOPLE NEED TO REALIZE WE NEED
TO TAKE OFF THE TABLE.
BUT IF YOU LOOK AT THE
MARKETPLACE PLAN THAT THE SENATE
HAS PUT IN PLACE AND THAT WE
HAVE BEFORE US WITH THE
GENTLEMAN FROM SUFFOLK'S
AMENDMENT THAT I DON'T BELIEVE
HE'S GOING TO SUPPORT AND THAT I
DO NOT SUPPORT, THE PROBLEM IS,
THE INFORMATION THAT HE
MENTIONED, I JUST WANT TO
REITERATE, IS THE COST
ASSOCIATED WITH SETTING UP AN
EXCHANGE.
AND THAT COST IS ESTIMATED, AS
THE GENTLEMAN, I BELIEVE,
MENTIONED, AT 24.6 MILLION TO
$39.9 MILLION.
SO WE'VE GOT THAT COST RELATED
TO THIS AMENDMENT.
WE DON'T KNOW, IF YOU LOOK AT
THE LANGUAGE, IF YOU LOOK AT
NUMBER FIVE, WHETHER THE
SECRETARY WOULD GO THAT ROUTE OR
NOT.
BUT WHEN WE DO BUDGETING, WE
HAVE TO KIND OF LOOK AT WORST
CASE SCENARIOS, AND THAT WOULD
BE A WORST CASE SCENARIO FROM MY
STANDPOINT.
THE OTHER THING THAT THE
GENTLEMAN FROM SUFFOLK MENTIONED
AND THAT THE GENTLEMAN FROM
HENRICO WAS ASKING ABOUT WAS
RELATED TO, IN ADDITION TO THE
MARKETPLACE QUESTIONS, THE FACT
THAT MANY OF US WOULD LIKE TO
SEE A WORK REQUIREMENT AS PART
OF THE REFORMS RELATED TO AN
EXPANDED OR AN EXISTING
POPULATION FOR MEDICAID.
THE LANGUAGE IN THE SENATE
AMENDMENT TALKS ABOUT THE 5% OF
TOTAL HOUSEHOLD INCOME, AL HOW
LONG A COST SHARING OF UP TO 5%
OF THE TOTAL HOUSEHOLD INCOME.
THE PROBLEM WITH THAT, THERE'S
NOT BEEN ANY STATE THAT HAS BEEN
GRANTED A WAIVER FOR THAT
REQUIREMENT.
WE'VE LOOKED AT THIS FROM THE
MEDICAID INNOVATION REFORM
COMMISSION OVER THE LAST YEAR.
WE'VE ASKED AND ASKED AND
MONITORED AND MONITORED WHAT
OTHER STATES ARE DOING.
NO WAIVERS HAVE BEEN GRANTED
EXCEPTING THAT, SO YOU HAVE TO
TAKE THAT OFF THE TABLE AS PART
OF THIS PLAN.
THE OTHER THING I THINK THE
GENTLEMAN FROM HENRICO ASKED THE
CHAIRMAN WAS RELATED TO
ENACTMENT NUMBER FOUR, NUMBER
6 -- OR V-II RELATED TO ASKING
PERMISSION FROM THE FEDERAL
GOVERNMENT TO REQUIRE
PARTICIPATION IN WORK SEARCH
ACTIVITIES.
AGAIN, ANOTHER COMPONENT OF WHAT
ARE REFORMS THAT WE WOULD LIKE
TO SEE.
THE PROBLEM IS, NO OTHER STATE
HAS BEEN GRANTED THAT WAIVER.
SO THERE'S TWO OF THE
REQUIREMENTS FROM THE STANDPOINT
THAT'S INCLUDED IN THE SENATE'S
PLAN THAT THEY SHOULD KNOW, AT
LEAST THOSE THAT ARE ON THE
MEDICAID INNOVATION REFORM
COMMISSION, THAT HAVE NOT BEEN
GRANTED BY THE FEDERAL
GOVERNMENT.
THE OTHER THING, MR. SPEAKER, I
JUST WANT TO SAY ABOUT THIS
PLAN, AS THE CHAIRMAN MENTIONED,
IT DOES NOT BELONG IN THE
BUDGET.
THERE WAS A SEPARATE BILL,
SENATE BILL 45, AND THAT WOULD
HAVE BEEN APPROPRIATE.
I DON'T BELIEVE THE OTHER SIDE
OF THE AISLE PROPOSED THAT PLAN,
BUT THE SENATE HAD THAT PLAN,
DECIDED NOT TO MOVE THAT
LEGISLATION FORWARD SEPARATE
FROM THE BUDGET, AND DECIDED TO
INCLUDE IT IN THE BUDGET,
THEREFORE CAUSING THIS TO BE A
BUDGETARY ISSUE WHERE IT WAS NOT
BEFORE.
THE HOUSE, AS YOU ALL KNOW, TOOK
A SEPARATE APPROACH.
WE DECIDED THAT WE WOULD KEEP
SEPARATE THE ISSUE RELATED TO
MEDICAID AND THE POSSIBILITY OF
REFORM AND EXPANSION, SEPARATE
FROM THE BUDGET PROCESS AND HAD
AN AUDIT RESOLUTION THAT WENT
THROUGH THE PROCESS AND WAS
SUPPORTED BY THE HOUSE.
THE MAJORITY OF THE HOUSE.
WE DID NOT INCLUDE IT IN THE
BUDGET BECAUSE WE DID NOT WANT
TO TIE THIS ISSUE TO BUDGET
NEGOTIATIONS MOVING FORWARD.
SO THAT WE CAN TAKE OUR
RESPONSIBILITY AND END THE
PROCESS ON MARCH 8th WITH A
BUDGET CONFERENCE REPORT.
THE OTHER PART OF THE PLAN I
WANT TO POINT OUT, THAT IF YOU
LOOK AT THE PIECES JUST THAT
I'VE MENTIONED, THE QUESTIONS
THAT THE GENTLEMAN FROM HENRICO
ASKED THE CHAIRMAN, IT DOESN'T
EVEN STAND ON ITS OWN MERITS.
IN MY ESTIMATION, IT'S POORLY
CONCEIVED, THE LANGUAGE IS POOR
WORDED AND NOT CLEAR, SIMILAR TO
WHAT HAPPENED WITH THE FEDERAL
AFFORDABLE CARE ACT.
MR. SPEAKER AND LADIES AND
GENTLEMEN OF THE HOUSE, AS
POINTED OUT, I THINK THE
GENTLEMAN FROM HENRICO AND THE
CHAIRMAN HAVE POINTED OUT, THIS
AMENDMENT IS NOT APPROPRIATE TO
BE INCLUDED IN THE BUDGET.
I THINK IT IS IMPORTANT WE'RE
HAVING THIS VOTE TODAY SO WE CAN
KNOW WHERE THE HOUSE STANDS ON
THIS ISSUE ABOUT INCLUSION OF
THIS KIND OF PROCESS THAT THE
SENATE HAS PROPOSED AS PART OF
THE BUDGET PROCESS.
IT SHAN'T BE IN THE BUDGET --
SHOULDN'T BE IN THE BUDGET.
IT'S ILL CONCEIVED, AND MORE
IMPORTANTLY, THERE ARE MORE
QUESTIONS, MORE QUESTIONS WE
COULD ASK ON HOW THIS WOULD
WORK, WHAT IT WOULD DO OR NOT
DO, AND MR. SPEAKER, I THINK THE
HOUSE, WE HAVE TRIED AND TRIED
TO LOOK AT REFORMS.
WE'RE GOING TO CONTINUE THAT
PROCESS.
THE OTHER PART OF THE SENATE
PLAN WOULD TAKE AWAY THE
RESPONSIBILITIES RELATED TO THE
MEDICAID INNOVATION REFORM
COMMISSION, WHICH WOULD TAKE
AWAY LEGISLATIVE RESPONSIBILITY,
WHICH WAS THE ORIGINAL INTENT OF
THE MEDICAID INNOVATION REFORM
COMMISSION.
SO I HOPE YOU WILL NOT SUPPORT
THIS MEASURE, YOU ALLOW THE
COMMISSION TO MOVE FORWARD,
CONTINUE TO LOOK AT REFORMS, SEE
IF WE CAN HAVE AN AGREEMENT
THERE, AND MORE IMPORTANTLY, NOT
ENTANGLE THIS DEBATE ON THIS
ISSUE AND MAKING SURE THAT WE
GET OUR BUDGET DONE ON TIME AND
IN AN EFFECTIVE AND EFFICIENT
MANNER.
THANK YOU, MR. SPEAKER.
>> THE GENTLEMAN FROM ARLINGTON,
MR. HOPE.
>> THANK YOU, MR. SPEAKER.
SPEAK IN FAVOR OF THE AMENDMENT.
>> JAT HAS THE FLOOR.
>> A COUPLE POINTS TO MAKE VERY
CLEAR TO THE GENTLEMAN FROM
AUGUSTA.
I WOULD PUT IN A BILL, BUT I
FEAR IT PROBABLY WOULD HAVE BEEN
ASSIGNED TO THE COMMERCE AND
LABOR COMMITTEE, AND I DON'T
THINK WE'D OBJECT THE FLOOR
RIGHT NOW TALKING ABOUT MY BILL,
WOULD WE?
I WOULD HAVE DONE THAT HAD I
THOUGHT WE HAD THAT OPPORTUNITY,
SO I THANK THE GENTLEMAN FROM
SUFFOLK FOR PUTTING THAT IN.
AND LET ME ALSO MAKE CLEAR TO
THE GENTLEMAN FROM AUGUSTA THAT
I DON'T THINK HE'S REVIEWED
EVERY SINGLE PLAN WAIVER THAT
EVERY STATE HAS PUT IN.
THE GOING WORD FROM THE FEDS
WILL BE FLEXIBILITY AND IF THE
GENTLEMAN IS AWARE OF A STATE
PUT IN A WORK REQUIREMENT, 000
NO REASON WE COULDN'T MAKE THAT
PART OF IT.
WHAT ARE YOU AFRAID OF?
LET'S PUT ALL OF OUR
REQUIREMENTS IN THERE AND LET'S
GO TO THE FEDS AND IF THEY SAY
NO, WE DON'T DO IT.
WHAT'S WRONG, WHAT ARE YOU
AFRAID OF TO IT IT IN RIGHT HERE
ON THE FLOOR TO DO THAT?
>> IN SPEAKER, MR. SPEAKER.
>> GENTLEMAN FROM SUFFOLK.
>> I WOULD ASK THE GENTLEMEN A
QUESTION?
>> THE GENTLEMEN YIELDS.
>> IS THE GENTLEMAN AWARE THAT A
STAY HAS REQUESTED A WORK
REQUIREMENT AND HAS NOT BEEN
APPROVED AS OF YET.
>> I'M NOT AWARE OF THAT STATE.
>> I THINK THE STATE WOULD BE
THE COMMONWEALTH OF
PENNSYLVANIA.
>> I GUESS I WOULD SAY IT HASN'T
BEEN REJECTED YET EITHER, HAS
IT, AND THAT IS THE POINT.
WE CAN DO WHATEVER WE WANT IN
VIRGINIA, WE CAN PLAY BY THE
RULES BY THE WAY WE WANT TO DO
IT.
IT'S UP TO US ENTIRELY AND WE
CAN LEG A LITTLE THAT RIGHT
HERE -- LEGISLATE THAT RIGHT
HERE.
I THINK IT BOWELS DOWN TO
THREE -- BOILS DOWN TO THREE
DIFFERENT QUESTIONS.
WE'RE TRYING TO HIDE THE BALL,
BUT LET'S TALK ABOUT WHAT WOULD
HAPPEN IF WE MADE A PLAN AND
THAT'S WHAT I'M DISAPPOINTED
ABOUT.
REPUBLICANS AND THE MAJORITY
DON'T HAVE A PLAN.
AT LEASE THE SENATE CAME UP WITH
A PLAN.
IF YOU HAVE A BETTER IDEA, I'D
LIKE TO HEAR IT.
THE ONLY THING I'VE HEARD FROM
THE OTHER SIDE IS LET'S DA AN
AUDIT.
THAT'S NOT A PLAN, THAT'S A
STALL TACTIC.
MEANWHILE, WE HAVE PEOPLE
UNINSURED AND WORRIED ABOUT
GETTING SICK AND GOING INTO
FINANCIAL BANKRUPTCY AND WE'RE
WORRIED ABOUT DOING AN AUDIT?
LET'S COME UP WITH OUR OWN
IDEAS, THAT'S WHY THEY PAY US TO
BE HERE.
THAT'S WHY WE'RE ELECTED
OFFICIALS.
LET'S MAKE SOME DECISIONS.
DO WE RECOVERY $6.9 BILLION
BETWEEN NOW AND 2018 FM WE'RE
ALREADY PAYING IT.
IF YOU THINK WE'RE NOT PART OF
THE AFFORDABLE CARE ACT, WE'RE
ALREADY ON THE HOOK.
WE'RE ALREADY PARTICIPATING.
OUR TAXPAYERS ARE ALREADY PAYING
MONEY TO THE FEDERAL GOVERNMENT.
YOU CAN'T GET OUT OF THAT, YOU
CAN'T PRETEND THAT DOESN'T
HAPPEN.
UNCLE SAM IS FOR THE GOING TO
GIVE US A REFUND.
DO WE ENABLE VIRGINIA TO SAVE AN
ADDITIONAL $800 MILLION BY
PARTICIPATING BY REDUCING WHAT
WE ALREADY SPEND IN MENTAL
HEALTH AND WHAT JAT WAS TALKING
ABOUT FROM ROANOKE, AN INDIGENT
CARE.
WE'RE ALREADY PAYING FOR IT.
IF I COULD WAVE A MAGIC WAND AND
SAY EVERYONE THAT'S UNINSURED,
DON'T GET SICK, PLEASE, WE CAN'T
AFFORD YOU ANYMORE, THAT'S NOT
REALITY.
WE'RE PAYING FOR IT NOW,
FRIENDS, AND THE QUESTION REALLY
IS, IS WHO DO WE RATHER PAY?
WHAT HAPPENS NOW IF I'M
UNINSURED AND I HAVE A HEART
ATTACK, I GO TO THE HOSPITAL?
DO YOU THINK I PAY FOR THAT?
OF COURSE NOT.
OUR HOSPITALS PAY FOR IT.
THAT GOES INTO OUR SHURND,
INDIVIDUALS WHEN THEY PAY
PRIVATE COVERAGE, BUSINESSES,
THAT'S WHY THE CHAMBER OF
COMMERCE SUPPORTS IT.
THE ONLY THING OBAMACARE DOES IS
IT SAYS THAT FEDERAL DOLLARS ARE
GOING TO PAY FOR IT INSTEAD OF
YOUR PREMIUM DOLLARS.
WE'RE JUST RENEGOTIATING.
THAT'S ALL WE'RE DOING HERE.
AND SO TO TALK ABOUT ALL -- I
ONES GO THROUGH ALL THE
DIFFERENT THINGS THAT'S LAID OUT
IN THE BUDGET AMENDMENT, BUT
THIS IS NOT THE AFFORDABLE CARE
ACT.
BY DEFINITION, THAT'S WHAT A
WAIVER IS.
IT'S SAYS WE WANT TO DO
SOMETHING DIFFERENT THAN WHAT
THE FEDERAL LAW IS ASKING US.
AND AGAIN, WE CAN SET THE GROUND
RULES OURSELVES, LET'S NOT BE
AFRAID TO DO THAT.
EVERYTHING IN HERE, IF YOU LIKE
WHAT'S IN HERE, LET'S PUT IT IN.
IF YOU HAVE OTHER IDEAS, OTHER
MECHANISMS, PUT THEM IN.
THAT'S WHAT WE'RE HERE, THIS
PROCESS IS ABOUT.
LET ME BE CLEAR, THERE'S A
TRIGGER IN THERE THAT SAYS THAT
LOOKING, IF THE FEDERAL
GOVERNMENT RENEGES, THEN WE CAN
GET OUT OF IT.
IF PEOPLE THAT ARE INSURED, WE
CAN MAKE VERY CLEAR TO THEM,
WRITE YOUR CONGRESSMAN, WRITE
YOUR TWO SENATORS, TELL THEM NOT
TO ALLOW THAT TO HAPPEN, BUT
THERE'S THE ONES THAT GET
BLAMED.
I'M TELL YOU, LET ME BE VERY
CLEAR ABOUT THIS POINT, WE HAD
AN ISSUE WITH TRANSPORTATION
LAST YEAR WHERE THE FEDERAL
GOVERNMENT WAS GOING TO TAKE OFF
FUND.
WE DIDN'T KICK IN MATCHING
DOLLARS.
WII I DIDN'T HEAR ANYONE THEN
SAY, OH, THE FEDERAL GOVERNMENT
COULD RENEGE.
WE TAKE MONEY FROM
TRANSPORTATION, DON'T WE?
WE TAKE MONEY FOR TEACHERS,
EDUCATION, PUBLIC SCHOOLS, FOR
PUBLIC SAFETY FROM THE FEDS.
I DON'T HEAR ANYONE HERE SAYING
WE'RE GOING TO CUT THAT OFF
BECAUSE THE FEDERAL GOVERNMENT
COULD RENEGE.
I DON'T KNOW WHAT TO THINK OF
WHY WE'RE DOING THAT.
SO LET'S RECAP HERE.
WE LAY DOWN A PATHWAY IN THIS
BUDGET AMENDMENT THAT CLOSES THE
COVERAGE GAP.
250,000 TO 300,000 PEOPLE COULD
BE COVERED BY THIS.
WHY IS GOVERNMENT STANDING IN
THE WAY OF THEM HAVING HEALTH
INSURANCE?
I CAN'T UNDERSTAND WHY ANYONE
WOULD DO THAT.
IT RECOVERS $6.9 BILLION FROM
OUR OWN MONEY THAT WE'RE
SPENDING AND WE RECAPTURE
800 MILLION THAT WE'RE ALREADY
SPENDING, THAT WE COULD USE FOR
OTHER THINGS.
I KNOW PEOPLE PROBABLY HAVE
OTHER IDEAS OF HOW YOU CAN SPEND
THAT MONEY.
LET'S HAVE A CONVERSATION OF
WHERE IT GOES, BUT THIS IS OUR
MONEY.
IT DOESN'T BELONG TO US.
IT BELONGS TO OUR TAXPAYERS.
WE NAED TO SPEND IT WISELY.
IF YOU HAVE A BETTER PLAN, LET'S
DO IT, LET'S PUT POLITICS ASIDE,
PUT PARTY ASIDE, LET'S PUT OUR
PEOPLE'S INTERESTS AHEAD OF OUR
OWN PERSONAL POLITICAL
INTERESTS.
VOTE YES ON THIS AMENDMENT.
[ APPLAUSE ]
>> THE GENTLEMAN FROM LOUDOUN,
MR. GREESON.
>> THANK YOU, MR. SPEAKER.
MR. SPEAKER, I HAVE A COUPLE
QUESTIONS AND I'M NOT SURE WHO
TO DIRECT THEM TO.
I MIGHT DIRECT THEM TO THE
GENTLEMAN FROM ROANOKE,
MR. RASOUL, IF HE WOULD YIELD.
>> WOULD THE GENTLEMAN YIELD?
>> I YIELD FOR MY TEAMMATE.
>> THANK YOU, I APPRECIATE IT.
MR. SPEAKER, I'D ASK THE
GENTLEMAN, AND I'M GOING TO DO A
LITTLE BIT OF A DAVE ALBO HERE.
THIS IS NOT MY AREA OF EXPERTISE
AND IF I HAVE QUESTIONS, I GAR
RAN STAE THERE'S OTHER PEOPLE
HERE WHO HAVE QUESTIONS, AND SO
MAYBE I COULD ASK THE FIRST
QUESTION.
IF WE WERE TO ADOPT THIS
AMENDMENT AND VOTE ON IT HERE IN
A COUPLE MINUTES, AND I'LL BE
BRIEF TO IT IS JUST A COUPLE
MINUTES, HOW WOULD VIRGINIANS
SIGN UP TO GET THESE BENEFITS?
HOW WOULD IT WORK?
>> I THINK THAT THEY HAVE
OUTLINED THAT WE WOULD SET UP A
MARKETPLACE.
THE GOOD NEWS THAT IS WE
CURRENTLY ALREADY HAVE SEVEN
ORGANIZATIONS IN THE STATE OF
VIRGINIA THAT ARE EQUIPPED TO
HANDLE THIS TYPE OF POPULATION,
SO I BELIEVE THAT IT WOULD
TRANSITION THROUGH THEM.
>> MR. SPEAKER, WOULD THE
GENTLEMAN YIELD FOR ANOTHER
QUESTION?
>> THE GENTLEMAN YIELD?
>> I YIELD.
>> THE GENTLEMAN YIELDS.
>> MR. SPEAKER, I'D ASK THE
QUESTION, IF IT IS SET UP, WOULD
ENROLLMENT BE MANDATORY?
WOULD EVERYBODY WHO WANTED TO
QUALIFY IN THIS CATEGORY FROM
100% TO 138% OF POSITIVE VERSE,
WOULD IT BE MAN -- POVERTY,
WOULD IT BE MANDATORY FOR THEM
TO SIGN UP FOR THE PROGRAM?
>> WE HAVE TO BE CAREFUL BECAUSE
IT'S NOT NECESSARILY
SPECIFICALLY FOR 100 TO 138%
ONLY, SO WHERE OUR THRESHOLD IS
IS AT 40%, SO WE'RE REALLY
TALKING ABOUT THE POPULATION
BETWEEN 40% OF THE FEDERAL
POVERTY LEVEL ALL THE WAY UP TO
138%, SO JUST TO BE CLEAR, A
FAMILY OF FOUR, THE FEDERAL
POVERTY LINE IS ABOUT $23,000.
40% OF THAT IS AROUND $8500.
SO THOSE INDIVIDUALS WOULD THEN
BE ABLE TO QUALIFY TO
PARTICIPATE IN THIS EXCHANGE
POTENTIALLY.
>> MR. SPEAKER, I'LL ASK THE
GENTLEMAN ANOTHER QUESTION IF I
MIGHT.
>> WOULD THE GENTLEMAN YIELD?
>> I YIELD.
>> THE GENTLEMAN YIELDS.
>> THE QUESTION I ASK, AND
THANKS FOR THE CHAIR -- CLARITY
STI ON THE RANGE, BUT SIT MAN ZA
TOER?
>> IT WOULD NOT BE MANDATORY.
15E6% OF THOSE -- 65% OF THOSE
THAT WOULD QUALIFY WOULD
ACTUALLY END UP SIGNING UP, SO
THE WAY IT IS WRITTEN NOW, IT IS
NOT MANDATORY.
>> I'D ASK ANOTHER QUESTION.
>> WOULD THE GENTLEMEN YIELD?
>> I YIELD.
>> HAS CMS EVER APPROVED AN
OPTIONAL EXPANSION?
SO IF IT'S NOT MANDATORY, HAVE
WE EVER APPROVED SOMETHING THAT
WOULD ALLOW AN OPTIONAL, SO FOUR
OR FIVE PEOPLE SIGN UP,
EVERYBODY SIGNS UP?
HOW DOES THE APPROVAL PRACTICE
SES WORK IF IT'S NOT A MANDATORY
ENROLLMENT PROCESS?
>> THAT ACTUALLY NEEDS TO BE
HASHED OUT.
THE LEGISLATION TALKS ABOUT THE
MECHANISMS WE WOULD GO THROUGH,
THE MECHANIC NUSMS WE WOULD GO
THROUGH, MR. SPEAKER, TO OUTLINE
WHAT THE QUALIFICATIONS WOULD
BE, BUT RIGHT NOW THEY HAVE NOT
COME UP WITH ALL OF THE DETAILS.
>> MR. SPEAKER, I'D ASK AN
ADDITIONAL QUESTION.
>> WILL THE JUDGE YIELD?
>> I YIELD.
>> THE GENTLEMAN YIELDS.
>> AND ONE OF THE THINGS THAT WE
ALWAYS WORRY ABOUT IS THINGS
THAT GET HASHED OUT AT THE END,
BUT WE'RE VOTING ON THE LANGUAGE
THAT'S BEFORE US NOW, SO IF IT
DOESN'T GET HASHED OUT PROPERLY,
WHAT ARE THE CONSEQUENCES OF
IT'S NOT GETTING HASHED OUT?
>> THAT, YOU KNOW, WE'RE TALKING
ABOUT THE CONSEQUENCES OF A
PIECE OF LEGISLATION THAT HASN'T
PASSED, SO I THINK THAT WE WOULD
NEED TO SEE WHAT WOULD HAPPEN IN
CONFERENCE TO ENSURE THAT WE
HAVE AN AGREEMENT.
SO WE CERTAINLY CANNOT SPECULATE
RIGHT NOW WHAT WOULD HAPPEN IF
THOSE DETAILS WERE NOT HASHZ
OUT.
>> WE'RE GOING TO HAVE TO PASS
THE BILL TO SEE WHAT'S IN IT.
>> THAT'S RIGHT.
[ LAUGHTER ]
>> I'M NOT SURE WHO SAID THAT.
>> THAT'S RIGHT, MR. SPEAKER.
>> MR. SPEAKER, I THINK I HAVE
TWO MORE QUESTIONS.
>> WILL THE GENTLEMAN YIELD?
THE GENTLEMAN YIELDS.
>> I YIELD.
>> MR. SPEAKER, THE LAST TWO
QUESTIONS I HAVE ARE RELATING TO
THE LANGUAGE THAT'S BEFORE US
AND THE REQUIREMENTS THAT ARE
LAID OUT HERE IN THE BILL.
[ CAPTIONING WILL RESUME
SHORTLY ]
>> WE ALSO LEARNED IN THE
MICHIGAN EXAMPLE THAT ONCE YOU
ENROLL AND YOU DECIDE NOT TO PAY
THAT 2%, YOU CAN NEVER BE
UNENROLLED FROM THE PROGRAM, NOT
BECAUSE OF WHAT MICHIGAN SAID
BUT BECAUSE OF THE FEDERAL
GOVERNMENT.
SO IF WE WERE TO PUT A PROVISION
IN HERE THAT SAYS THERE'S 5% OR
2% OR 10% OR 3% OF COST SHARING,
HOW DID WE INSURE, BECAUSE WE
CAN'T, THAT THESE INDIVIDUALS
WILL, IN FACT, PAY THEIR SHARE
OF THE COST AND NOT JUST
CONTINUE TO GET THE BENEFIT AND
NOT PAY THEIR SHARE OF THE COST?
>> THANK YOU, MR. SPEAKER.
I WOULD TELL THE GENTLEMAN THAT,
IN FACT, THIS IS AGAIN A WAVER
PROCESS, SO WE WOULD PUT THAT
INFORMATION INSIDE OF THE
REQUEST.
I WOULD LIKE TO REFERENCE, KEY
CARE 30 THAT SPECIFICALLY TALKS
ABOUT CO-PAYS, WHICH IS PART OF
THE 5%.
SO INDIVIDUALS THAT WOULD LIKE
TO PARTICIPATE WOULD NEED TO NOT
ONLY MEET CERTAIN DEDUCTIBLES
BUT HAVE TO PAY CERTAIN CO-PAYS
TO ENSURE THEY DO HAVE SOME
PERSONAL RESPONSIBILITY.
>> MR. SPEAKER, SPEAKING TO THE
BILL AT THE APPROPRIATE TIME.
>> GENTLEWOMAN FROM FAIRFAX,
MS. FILLER-CORN.
>> MR. SPEAKER, SPEAKING IN
SUPPORT OF THE AMENDMENT.
>> GENTLEWOMAN HAS THE FLOOR.
>> TODAY'S VOTE, LADIES AND
GENTLEMEN, IS AN IMPORTANT STEP
AS WE COME UP WITH A PLAN TO USE
A SUBSTANTIAL FUNDING THAT HAS
BEEN SET ASIDE TO CLOSE THE
COVERAGE GAP FOR SO MANY OF OUR
WORKING VIRGINIANS AROUND THE
COMMONWEALTH.
A STEP FOR OUR ECONOMY TO
BENEFIT FROM $5 MILLION PER DAY,
A STEP TO CREATE UP TO 23,000
HEALTH CARE RELATED JOBS, A STEP
TO HELP KEEP OUR HOSPITALS OPEN
AND TEND TO PATIENTS AND PROVIDE
JOBS FOR SO MANY IN DIFFERENT
REGIONS THROUGHOUT THE
COMMONWEALTH OF VIRGINIA.
AND AS WE HAVE HEARD FROM MANY
OF OUR COLLEAGUES, MANY
REPUBLICAN GOVERNORS HAVE
BASICALLY SAID YES AND HAVE
EXPANDED MEDICAID IN THEIR
STATE.
GOVERNORS BREWER OF ARIZONA,
MARTINEZ OF NEW MEXICO, NEVADA,
OHIO.
IN ADDITION, THE REPUBLICAN
GOVERNOR OF UTAH HAS ALSO
INDICATED A DESIRE TO EXPAND
MEDICAID IN HIS STATE.
AND I SUSPECT, MR. SPEAKER AND
LADIES AND GENTLEMEN OF THE
HOUSE, IN THE COMING MONTHS
WE'LL HEAR MANY MORE REPUBLICAN
LED STATES MOVING FORWARD TO
CLOSE THE COVERAGE GAP.
HOWEVER, NOW WE'RE DISCUSSING
AND DEBATING, WHAT WE'RE
DISCUSSING AND DEBATING NOW WILL
SOON BE TO VOTE ON THE SENATE'S
BIPARTISAN MARKETPLACE VIRGINIA
PLAN.
INSTEAD, THERE THEREFORE, I WANO
FOCUS ON STATES OF IOWA AND
MICHIGAN, ALSO TWO STATES WITH
REPUBLICAN GOVERNORS, AS WELL AS
ARKANSAS AND THEIR REPUBLICAN
LEGISLATURE, WHAT HAS BEEN
REFERENCED MANY TIMES ON THE
FLOOR HERE.
WHAT DO ALL OF THESE STATES HAVE
IN COMMON, MR. SPEAKER AND
LADIES AND GENTLEMEN?
THEY ALL HAVE COME UP WITH THEIR
OWN VERSIONS OF CLOSING THE
COVERAGE GAP, AS YOU'VE HEARD
TODAY.
JUST AS THE OTHER BODY HAS DOWN
THE HALL.
WORKING IN A BIPARTISAN MANNER.
LEADERS IN THESE STATES HAVE
SAID, LET'S FIND A WAY TO MAKE
THIS WORK.
STATES LIKE MICHIGAN AND
ARKANSAS AND IOWA HAVE COME UP
WITH PLANS SPECIFIC TO THEIR
NEEDS, WHAT WILL WORK WITH THEM,
WHAT WILL WORK FOR THEM IN THEIR
STATES.
THEY'VE RECEIVED FEDERAL
APPROVAL FOR THEIR PLANS, AND
IT'S EVIDENT, AS YOU'VE HEARD
TODAY, AND AS YOU PROBABLY
GATHER FROM READING, THAT THE
ADMINISTRATION HAS BEEN WORKING
WITH THESE STATES TO COME UP
WITH PLANS THAT SPECIFICALLY
WORK WITH THEM, AND MR. SPEAKER,
AND LADIES AND GENTLEMEN OF THE
HOUSE, I'M CONFIDENT THEY'LL
WORK WITH US, TOO, IF WE TRY TO
COME FORWARD WITH A PATH FORWARD
ON THIS ISSUE.
I URGE MY COLLEAGUES TO SUPPORT
THIS AMENDMENT, BECAUSE THIS IS
THE FIRST STEP IN USING FUNDS
AVAILABLE TO US TO HELP CLOSE
THE COVERAGE GAP.
LET'S MAKE THIS WORK TOGETHER.
IF WE CAN COME UP WITH A PLAN,
IT SHOWS THAT WE WANT TO MAKE IT
EASIER FOR WORKING INDIVIDUALS
TO GET PREVENTIVE CARE, TO GO TO
A DOCTOR, A CLINIC, MAYBE GET AN
ANTIBIOTIC FOR A CHEST COLD
RATHER THAN WAIT AND HAVE TO GO
TO THE EMERGENCY ROOM WITH
PNEUMONIA.
IT SHOWS THAT WE WANT PEOPLE TO
HAVE ACCESS TO HEALTH CARE SO
THAT THEY CAN STAY WELL AND GO
TO WORK.
IT WILL SHOW THAT WE WANT TO
HELP PEOPLE THAT NOW HAVE TO
CHOOSE BETWEEN GETTING THEIR
PRESCRIPTION DRUGS AND HEATING
THEIR HOMES.
WE'RE BEING ASKED TO VOTE ON
MANY ITEMS THIS THIS BUDGET.
WE'VE BEEN STANDING AND SITTING
HERE FOR HOURS TODAY, AND SO
OFTEN, TIME AND TIME AGAIN, WE
HAVE TO MAKE REALLY TOUGH
DECISIONS ABOUT WHAT PROGRAMS TO
CUT.
WE CAN'T IMPLEMENT ALL OF THEM,
BECAUSE WE DON'T HAVE THE MONEY,
BUT YOU KNOW WHAT, MR. SPEAKER,
AND LADIES AND GENTLEMEN OF THE
HOUSE, IN THIS CASE, THE MONEY
IS THERE.
IT'S JUST SITTING THERE WAITING
FOR US TO FIND A WAY TO TAKE IT.
UNLIKE MANY OTHER STATES THIS,
BODY FINISHES ITS WORK EARLY IN
THE YEAR.
IF WE DO NOTHING THIS SESSION TO
CLOSE THE COVERAGE GAP BEFORE WE
ADJOURN, WE ARE TELLING OUR
CONSTITUENTS THAT THEY HAVE TO
WAIT ANOTHER YEAR, PERHAPS EVEN
MORE, AND DURING THIS YEAR WE'LL
BE WATCHING STATE AFTER STATE
LED BY DEMOCRATIC AND REPUBLICAN
GOVERNORS TAKE ADVANTAGE OF THE
FUNDS SET ASIDE FOR THEM TO
COVER THEIR PEOPLE.
WE OFTEN SPEAK, MR. SPEAKER,
ABOUT THE VIRGINIA WAY.
THE VIRGINIA WAY INVOLVES
COLLABORATION.
COLLABORATION IS THE ENEMY OF
GRIDLOCK.
OUR ACTIONS NOW WILL SHOW THE
VIRGINIA WAY OF THE FUTURE.
IF WE VOTE YES FOR THE
MARKETPLACE VIRGINIA PLAN, IT
WILL REPRESENT A WILLINGNESS TO
MAKE SOMETHING WORK FOR 400,000
WORKING VIRGINIANS, AND YOU KNOW
WHAT A NO VOTE MEANS?
IT MEANS NO TO MOVING FORWARD.
IT MEANS THERE'S NO DESIRE TO
EVEN FIND A WAY TO TAKE
ADVANTAGE OF THREE YEARS OF FULL
FEDERAL FUNDING TO GIVE SO MANY
OF OUR CONSTITUENTS, VIRGINIANS,
HEALTH CARE COVERAGE.
I TRULY, TRULY BELIEVE THAT
THERE IS A DESIRE AND THAT THERE
IS A WAY OUT THERE WHERE WE CAN
WORK AROUND, WORK TOGETHER TO
FIGURE OUT WHAT WORKS FOR THE
COMMONWEALTH OF VIRGINIA, WHAT
WORKS FOR ALL OF OUR CITIZENS.
I BELIEVE THIS BECAUSE WE HAVE
ALL DONE THIS TIME AND TIME
AGAIN HERE IN THE COMMONWEALTH
OF VIRGINIA.
LET'S TAKE THIS STEP, MR.
SPEAKER, AND LADIES AND
GENTLEMEN OF THE BODY.
LET'S TAKE CARE OF OUR PEOPLE.
LET'S MAKE THIS WORK.
PLEASE JOIN ME IN VOTING YES FOR
THIS AMENDMENT.
THANK YOU.
>> THE GENTLEMAN FROM DANVILLE,
MR. MARSHALL.
>> MR. SPEAKER, I HAVE A MOTION.
I MOVE THE PENDING QUESTION.
>> THE GENTLEMAN FROM DANVILLE,
MR. MARSHALL, MOVES THE PENDING
QUESTION.
AS MANY AS FAVOR THAT MOTION,
SAY AYE.
THOSE OPPOSED, NO.
THE PENDING QUESTION IS CALLED
FOR.
THE PENDING QUESTION IS ON THE
ADOPTION OF THE FLOOR AMENDMENT
OFFERED BY THE GENTLEMAN FROM
SUFFOLK.
>> SPEAKING TO THE MOTION.
>> WELL, THE PENDING QUESTION
HAS BEEN CALLED.
>> PARLIAMENTARY INQUIRY.
>> GENTLEMAN MAY STATE IT.
>> HAVE WE ALREADY VOTED ON THE
PENDING QUESTION?
>> UH-HUH.
>> WHAT A SHAME.
I WOULD ASK THAT YOU WOULD
VOTE -- I CAN'T DO.
IT I'M NOT GOING TO BREAK THE
RULES.
JUST VOTE NO.
>> I THINK WE KNEW THAT.
THE QUESTION IS ON THE ADOPTION
OF THE AMENDMENT OFFERED BY THE
GENTLEMAN FROM SUFFOLK,
MR. JONES, WHICH HE DOESN'T
LIKE.
AS MANY AS FAVOR THAT AMENDMENT
WILL SAY AYE.
(LAUGHTER).
THOSE OPPOSED, NO.
>> YOU KNOW, I THINK IT'S
SUPPOSED TO BE RECORDED ANYWAY.
SHALL THE AMENDMENT BE AGREED
TO?
THE CLERK WILL CLOSE THE ROLL.
>> AYES 32, NOS 67.
>> AYES 32, NOS 67.
THE AMENDMENT IS REJECTED.
THE GENTLEMAN FROM SUFFOLK,
MR. JONES.
>> MR. SPEAKER, I MOVE THAT THE
THIRD CONSTITUTIONAL READING FOR
HOUSE BILL 30 BE DISPENSED.
>> SHALL THE CONSTITUTIONAL
READING BE SUSPENDED?
>> THE CLERK WILL CLOSE THE
ROLL.
>> AYES 99, NOS 0.
>> AYES 99, NOS 0.
THE CONSTITUTIONAL READING IS
SUSPENDED.
SHALL THE BILL PASS?
THE CLERK WILL CLOSE THE ROLL.
>> AYES 74, NOS 25.
>> AYES 74, NOS 25.
THE BILL IS PASSED.
>> THAT COMPLETES THE SPECIAL
ORDER.
WE'RE BACK IN REGULAR CALENDAR
NOW.
GENTLEMAN FROM COLONIAL HEIGHTS,
MR. ***.
THE HOUSE WILL BE AT EASE.
>> HOUSE WILL COME TO ORDER.
HOUSE WILL COME TO ORDER.
PLEASE TAKE YOUR SEATS.
THE GENTLEMAN FROM COLONIAL
HEIGHTS, MR. ***.
>> MR. SPEAKER, I'M GOING TO
MOVE THE REMAINDER OF THE
CALENDAR GO BY FOR THE DAY.
(APPLAUSE).
>> AS MANY AS FAVOR THAT MOTION,
SAY AYE.
THOSE OPPOSED, NO.
>> THAT MOTION IS AGREED TO.
>> MR. SPEAKER, THAT COMPLETES
THE CALENDAR.
>> DOES THE CLERK HAVE ANY
ANNOUNCEMENTS?
>> MR. SPEAKER, I AM NOT AWARE
OF ANY MEETINGS THIS AFTERNOON
OR THIS EVENING, SO LOOKING
AHEAD TO TOMORROW,
FEBRUARY 21st, THE FINANCE
SUBCOMMITTEE NO. 3 WILL NOT BE
MEETING TOMORROW MORNING.
THAT MEETING IS CANCELLED.
FIRST MEETING COUNTY CITIES AND
TOWNS, WHICH WILL MEET AT 8 A.M.
IN HOUSE ROOM D.
THE TOURISM CAUCUS WILL MEET AT
8:45 IN THE FIFTH FLOOR WEST
CONFERENCE ROOM.
COMMITTEE ON MILITIA, POLICE AND
PUBLIC SAFETY AT 9 A.M. IN HOUSE
ROOM C.
PRIVILEGES AND ELECTIONS
COMMITTEE WILL MEET AT 9:30 A.M.
IN THE NINTH FLOOR
APPROPRIATIONS ROOM.
THE DEMOCRATIC CAUCUS WILL MEET
AT 10:30 A.M. IN HOUSE ROOM 2.
THIS IS A CHANGE IN TIME.
AND THE REPUBLICAN CAUCUS WILL
MEET AT 10:30 A.M., A CHANGE IN
TIME AS WELL.
>> GENTLEMAN FROM FAIRFAX,
MR. ALBO.
>> MR. SPEAKER, BEFORE YOU
RECOGNIZE THE GENTLEMAN FROM
CHESTERFIELD, CAN I MAKE A
MOTION?
>> IT'S OKAY WITH ME.
>> ON PAGE 2, SENATE BILL 96,
CAN YOU MOVE THAT TO REGULAR
CALENDAR FOR TOMORROW'S WORK,
PLEASE?
>> SENATE BILL 96 TO THE REGULAR
CALENDAR.
>> GENTLEMAN FROM PRINCE
WILLIAM, MR. ANDERSON.
>> COULD WE RETURN TO THE
MORNING HOUR JUST BRIEFLY FOR A
QUICK INTRODUCTION.
>> RETURNING TO THE MORNING
HOUR.
>> THANK YOU, MR. SPEAKER.
WE ARE OFTEN GRACED BY THE
PRESENTS OF SOME GREAT AMERICANS
HERE, AND I'D LIKE TO DO AN
INTRODUCTION, IF I COULD, VERY
QUICKLY, TO THE HOUSE.
SOME VERY DEAR FRIENDS OF MINE
JUST CAME INTO THE GALLERY A
SHORT WHILE AGO.
I'D LIKE TO INTRODUCE TO YOU
COLONEL FRAN MARTIN.
SHE IS A RETIRED UNITED STATES
AIR FORCE COLONEL WHO WORE THE
UNIFORM OF OUR COUNTRY FOR THREE
DECADES.
HER LAST ASSIGNMENT, SHE
COMMANDED THE 42nd AIR BASE
WING AT MAXWELL AIR FORCE BASE,
ALABAMA, WAS THE FIRST FEMALE TO
COMMAND THAT WING, WAS THE FIRST
NONAVIATOR TO COMMAND THAT WING.
SHE'S A GREAT AMERICAN.
SHE'S HERE WITH HER HUSBAND,
RICK, AND I WOULD ASK YOU TO
GIVE A WARM HOUSE WELCOME TO A
GREAT AMERICAN.
(APPLAUSE).
>> GENTLEMAN FROM COLONIAL
HEIGHTS, MR ***.
>> MR. SPEAKER, I MOVE THAT WHEN
THE HOUSE ADJOURN TODAY, IT
ADJOURN TO RECONVENE TOMORROW AT
11 A.M.
>> THE GENTLEMAN FROM COLONIAL
HEIGHTS, MR. *** -- HANG ON A
SECOND.
>> MR. SPEAKER, I APOLOGIZE.
THE MILITIA POLICE AND PUBLIC
SAFETY SUBCOMMITTEE NO. 1 WILL
MEET IMMEDIATELY UPON
ADJOURNMENT TODAY AT THE
CHAIRMAN'S DESK HERE, DELEGATE
WRIGHT, IN THE CHAMBER.
>> THE GENTLEMAN FROM COLONIAL
HEIGHTS, MR. ***.
>> MR. SPEAKER, I'LL TRY THAT
ONE AGAIN.
I MOVE THAT WHEN THE HOUSE
ADJOURN TODAY, IT ADJOURN TO
RECONVENE TOMORROW AT 11 A.M.
>> GENTLEMAN FROM COLONIAL
HEIGHTS, MR ***, MOVES THAT WHEN
THE HOUSE ADJOURN TODAY IT AGREE
TO RECONVENE TOMORROW AT 11 A.M.
AS MANY AS FAVOR THAT MOTION,
SAY AYE.
THOSE OPPOSED, NO.
MOTION AGREED TO.
GENTLEMAN FROM COLONIAL HEIGHTS,
MR ***.
>> MR. SPEAKER, I MOVE THE HOUSE
DO NOW ADJOURN.
>> GENTLEMAN FROM COLONIAL
HEIGHTS, MR ***, MOVES THE HOUSE
DO NOW ADJOURN.
AS MANY AS FAVOR THAT MOTION,
SAY AYE.
THOSE OPPOSED, NO.
THE MOTION IS AGREED TO.
THE HOUSE STANDS ADJOURNED UNTIL
11 A.M. TOMORROW.
>> MR. SPEAKER, THE MILITIA
POLICE PUBLIC SAFETY NO. NO. 1
COMMITTEE MEETING IS CANCELLED.