State of Virginia Budgeting After the Great Recession

After the Great Recession ended, incremental revenue growth provided the means for Virginia’s legislators and governors to slowly restore funding to many programs that were cut during that recession. Democratic legislators and governors, however, pushed for a nonincremental change in the state’s Medicaid program, which traditionally ranked among the bottom five states in its coverage. Republican legislators vehemently opposed Medicaid expansion, even though under provisions of the Affordable Care Act, the state could gain more than $2 billion in federal funding and provide health care coverage to an additional 400,000 Virginians. The partisan conflict over Medicaid expansion became the most visible budget and policy issue in three post-recession biennial budget processes, and it led to a budget impasse in two of those sessions. The 2018–2020 budgetary impasse was finally broken through a carefully negotiated compromise that allowed full Medicaid expansion but subjected new recipients, as well as the one million Virginians already covered by the state’s Medicaid program, to work requirements.