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This week, the House and Senate adopted their respective amendments to the Budget introduced by Governor Bob McDonnell. As introduced, the budget totaled $96 billion for the two-year period beginning July 1, 2014.
The major difference between the House and Senate budgets is the issue that has dominated this Session: Medicaid Expansion. I discuss the importance of expansion in my latest Richmond Times Dispatch Op-Ed.
In an effort to find a compromise, the Senate budget includes a proposal to allow Virginia to accept billions in federal funding to create a private insurance marketplace for low-income Virginians to receive health care insurance. This program, called "Marketplace Virginia," would close the health-care gap for approximately 250,000 Virginians using money already paid by Virginia taxpayers. The Senate plan includes cost-sharing by recipients, and unemployed recipients would have to shoe that they are looking for work. The Senate Finance Committee's Health & Human Resources Committee explained the importance of the Marketplace Virginia best:
By pursuing Marketplace Virginia, a home-grown, commonsense solution to providing access to health care for 250,000 uninsured Virginians. Rather than spend more than $137 million GF each year subsidizing the cost of care at Virginia hospitals, we can recapture at least $1.7 billion of our own money each year that is currently flowing across the Potomac with no benefit to the Commonwealth. Don't we know best how to spend Virginia taxpayer's dollars? This Subcommittee thinks so.
We can develop a system that provides access to primary care that encourages personal responsibility and healthy behaviors instead of funding a system that simply pays the emergency room bill when it comes due.
The cost of waiting to provide coverage can be measured in many ways. In financial terms, we are foregoing between $4 and $5 million each day. By the end of the year that total will balloon to $1.5 billion dollars. The cost of waiting is also reflected in a hidden tax that all Virginia policy holders will continue to pay; that annual cost may vary from $414 million to $2.0 billion.
But there is also a human cost of waiting that is difficult to quantify but very real. We know that many uninsured Virginians put off seeking care because they cannot afford it. So they show up in the emergency room in worse condition than someone with access to primary care. They receive disease diagnoses in the latter stages of an illness when interventions are more intensive, more expensive and less effective. That's not care...that's cost.
And there are also uninsured residents with mental illness living in all corners of the Commonwealth. Through Marketplace Virginia they could access more than $200 million dollars each year in hospital care, mental health counseling and medication management but also intensive community-based care and support. To individuals with mental illness who need help and to their families who go to bed each night worrying about their loved ones, we have an opportunity today to make a profound and lasting difference.
The Marketplace Virginia proposal was defeated on the House floor on a 32-67 mostly party-line vote. Instead, of spending $2 billion in federal funds to close the health insurance coverage gap, the House Budget uses $45 million in state tax dollars for inadequate funding to our hospitals providing indigent care and health care safety net providers. For these reasons, I voted against the House Budget.
In the end, the Budget Conferees will decide this issue. Hopefully, they will do so in time to pass a Budget before the Session's scheduled close on March 8th.
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Once again, the House Budget threatens women's access to health care through three amendments targeted at abortion. 
