RICHMOND — The General Assembly’s legislative money committees introduced spending proposals this week that take on new costs as Democratic legislators attempt to backfill cuts to federal health programs and expand some coverage.
The budget amendments, which would alter the original proposal of former Gov. Glenn Youngkin, a Republican, include funding for services such as emergency prenatal care for women who do not qualify for Medicaid due to their immigration status. They would also backfill the loss of federal tax credits for people who purchase their health insurance through the Affordable Care Act marketplace and restore language allowing Virginia Medicaid to fund abortions in cases severe fetal diagnoses.
Here’s a rundown of health-related coverage in the Senate and House proposed budget amendments:
Medicaid
Virginia Medicaid, called Cardinal Care, and Children’s Health Insurance Program, or CHIP, together cover nearly 1 in 4 Virginians.
The Senate version of the budget bill, as advanced by the Senate Finance and Appropriations Committee, includes $90 million in reserve to hedge against increasing Medicaid costs. In November, the projected cost for Medicaid was $3.2 billion in general fund dollars for fiscal years 2026 to 2028, according to the Senate Health and Human Resources subcommittee.
The Senate proposal would also allocate $200 million to backfill funding for premiums that keep insurance affordable for those who purchase it through the ACA marketplace. The House submitted a more modest $79.1 million for monthly premiums for those between 138% and 200% of the federal poverty level.
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The ACA tax credits expired at the end of 2025 when Congress failed to act to extend them. Their loss could mean 100,000 Virginians would lose access to health insurance as it becomes less affordable.
“We are doing our part to ensure Virginians can access affordable health care, even when the federal government is not stepping up,” said House Health and Human Services subcommittee chair Rodney Willett, D-Henrico, in remarks Sunday to the House Appropriations Committee.
The House and Senate versions restore funding — $29.5 million — that was removed under Youngkin’s proposal that allows women who would otherwise qualify for Medicaid but for their citizenship status to receive emergency maternity care.
And both versions restore language to the budget for Virginia Medicaid to fund abortions under circumstances where there are severe fetal diagnoses. That’s language Youngkin attempted to remove all four years of his term that was ultimately taken out during budget negotiations.
Disability services
When Youngkin proposed his budget in December, it did not include rate increases for people providing skilled nursing, private duty nursing, personal assistance respite care for people with developmental and intellectual disabilities who receive those services through Medicaid waivers. That matters because a federal court ordered the state to make best efforts to increase those rates after a rate study in order to receive less federal oversight on how the state treats people with disabilities.
The Senate version of the budget allots an additional $22.5 million for developmental disability services waiver rates.
“This amendment adds additional services that were not included in the introduced budget,” the budget explanation reads.
That language is absent from the House version.
“While we are encouraged that the Senate committee report makes investments in developmental disability waiver rates that go beyond what is required by a federal court order, it is incredibly disappointing that the House report includes no additional investments in waiver rates, including those required by the court,” Arc of Virginia Executive Director Tonya Milling said in a statement.
HIV/AIDS treatment
The Ryan White HIV/AIDS Program is the third largest source of federal funding for HIV care behind Medicare and Medicaid. It’s the largest source of federal funding specifically for people with HIV, according to the health reporting site KFF.
The House is proposing $13.2 million to backfill federal cuts to parts of that program, compared to the Senate’s $18 million.
Other
Both versions of the bill would move an existing nursing incentive program out from under the Virginia Department of Health and to the Virginia Health Workforce Development Authority. That was a policy proposed by Del. Mark Downey, D-York.
Both versions also propose $10 million over the biennium to Virginia’s free and charitable clinics. Democrats in the legislature say they expect the clinics to be increasingly burdened by people who lose access to health insurance coverage in the wake of federal cuts.
Kate Seltzer 757-713-7881, kate.seltzer@virginiamedia.com
