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Kaine says he'll work for compromise
Sen.-elect Tim Kaine speaks during a press conference
Steve Helber/ASSOCIATED PRESS
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There is a Nov. 16 deadline for states to declare whether they'll run their own health benefits exchanges or use a federal one, and McDonnell said federal officials haven't provided enough information about how a state-run program would work for Virginia to choose that option, even though the law is two years old.
It's expensive to build an exchange, he said, and it's possible there might be private-sector exchanges that could be cheaper or more efficient.
For now, he said, Virginia will go with the federal exchange, although there are other deadlines and options over the next couple of years that could allow Virginia to change that choice.
McDonnell said he also thinks it would be "irresponsible" for the state to expand its Medicaid coverage unless the federal government initiates "dramatic reforms to cut the cost."
Medicaid is a joint federal and state program, but the costs to states have ballooned in recent decades; McDonnell called it the largest budget driver in most state governments, and said the cost to expand it under the ACA could be $1 billion to $2 billion over the next decade.
It's so expensive, he said, that he doubts the federal government can afford to do it any more than states can, at least not without increasing the federal debt.
"I don't believe the federal government can possibly honor its commitment to the states to fully fund the program," McDonnell said.
Chelyen Davis: 540/368-5028