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People wait to receive a wristband number for medical treatment at the Remote Area Medical (RAM) clinic in Wise, Virginia July 20, 2012.  RAM clinics bring free medical, dental and vision care to uninsured and under-insured people across the country and a
People wait to receive a wristband number for medical treatment at the Remote Area Medical (RAM) clinic in Wise, Virginia July 20, 2012. They'll have to keep waiting, if the Republicans have their way.
Echoing the Arkansas fight to keep that state's Medicaid expansion, Virginia's House and Senate are divided on taking the expansion at all.
RICHMOND — Virginia’s Republican-controlled House of Delegates voted overwhelmingly Thursday to reject Medicaid expansion, signaling in the strongest terms yet that the chamber does not intend to budge on the marquee issue of this year’s legislative session.

With the 67 to 32 vote, an impasse is seen as all but inevitable with the state Senate, where Democrats and moderate Republicans have joined to support expanding Medicaid as allowed under the Affordable Care Act. Both houses passed their respective budget proposals Thursday, so the measure—and all other budget differences between the two chambers—will be taken up in negotiations next week.

And, much like Arkansas:
At its core, the debate is less a partisan brawl than a fight within the Republican Party. On one side is a conservative House caucus sticking to long-held principles of limited government and lower spending; on the other is a moderate group of GOP senators mindful of the changing political landscape of Virginia and motivated more by pragmatism than ideology to take advantage of federal largess.
The proposal at issue would require a federal waiver, as it would impose a requirement that unemployed recipients of coverage try to find work, a provision that Pennsylvania's Gov. Tom Corbett floated that was rejected by the federal government. It would also require that recipients buy in to the program, with up to five percent of their income, and has an escape clause allowing the state to back out of the expansion if for some reason the federal government failed to contribute it's portion of the funding. These are all conditions that might make the proposal unacceptable for the feds, even if the House were to pass it.

An estimated 255,000 people would gain coverage if Virginia took the expansion. That's something that state's more extreme Republicans—the ones who seem to be in control of the party everywhere—just can't stomach.

Originally posted to Joan McCarter on Fri Feb 21, 2014 at 01:10 PM PST.

Also republished by Virginia Kos and Daily Kos.

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