"Both issues are being considered on their own merits, by themselves," he said in a written statement.
The Senate and the House of Delegates offered substantially different approaches to Medicaid in conflicting versions of the budget. The Senate favored expanding the program to an additional 400,000 uninsured Virginians just over the poverty level, provided the state finds substantial savings and reforms and the federal government agrees to them. The House budget called for deferring expansion until those reforms are in place.
The compromise would establish a 12-member Medicaid Innovation and Reform Commission consisting of five members of the Senate Finance Committee, five members of the House Appropriations Committee and — as nonvoting members — the state secretaries of finance and health and human resources. The commission would determine when enough reforms were in place to begin expansion.
"They would be the approval authority," said House Majority Leader Kirk Cox, R-Colonial Heights and a member of the House budget negotiating team.
The commission would meet every other month, starting this summer. Any commission action would require the vote of at least three representatives from each chamber.
"That is a compromise I think everyone should be comfortable with," Howell said.
How well it will be received by the two-thirds GOP majority in the House remains to be seen, however.
"I would hope we would all stand firm in the House position," Del. Ben Cline, R-Rockbridge, told his colleagues on the House floor.
Under President Barack Obama's health care overhaul, states have the choice of whether to expand Medicaid, a federal-state program that helps pay for health care for the indigent, disabled, elderly, blind and low-income families with children. The federal government said it would pay the full cost of expansion for the first three years and 90 percent of the costs after that.