A. Specific provisions elsewhere in this Act permit the Department of Medical Assistance Services, on behalf of the Commonwealth, to amend the State Plan for Medicaid Assistance under Title XIX of the Social Security Act, and waivers thereof, to implement coverage for the newly eligible individuals pursuant to 42U.S.C. §1396d(y)(1)[2010] of the Patient Protection and Affordable Care Act. Based on an implementation date of January 1, 2017, this action will produce net general fund savings for the Commonwealth estimated at $59,171,815 the first year and $97,686,254 the second year.

B.1. Part of the estimated savings cited in A. above, shall be used to offset revenue losses resulting from the following tax policy changes contingent upon such changes being enacted into law by the 2016 session of the General Assembly:

a. An increase in the personal, dependent exemption for the Virginia personal income tax from $930 to $1,000 effective for tax year beginning on and after January 1, 2017 and an increase in the age, blind exemption for the Virginia personal income tax from $800 to $900 effective for tax years beginning on and after January 1, 2017 which together will result in general fund revenue losses estimated at $13,900,000 the first year and $28,100,000 the second year.

b. A tax rate reduction for the Virginia corporate income tax from 6 percent to 5.75 percent effective for tax years on and after January 1, 2017 which will result in general fund revenue losses estimated at $17,200,000 the first year and $46,500,000 the second year.

2. The fiscal impacts of these tax policy changes as cited in B.1.a. and B.1.b. above have been accounted for in the “Official Revenue Estimates” for general fund revenues listed in Enactment 1 of this Act.

C.1 The remainder of the net general fund savings estimated at $28,071,815 the first year and $23,068,254 the second year are hereby appropriated in this item for the following purposes:

a. An additional appropriation of $6,200,000 in the second year from the general fund to the Virginia Growth and Opportunity Fund to increase the per capita allocation to each qualifying region in the state from the $.75 per capita amount appropriated in this Act in Item 109 in the second year to $1.50 per capita. The Director of the Department of Planning and Budget is authorized to transfer this additional appropriation to Item 109 of this Act such that the aggregate amount in the second year for distribution to the qualifying regions for this purpose is $12,400,000.

b. An additional appropriation of $6,700,000 in the second year from the general fund to the Virginia Growth and Opportunity Fund to increase the $8,300,000 second year general fund appropriation provided for incentive grants in Item 109 to fund competitive project proposals or applications from qualifying regions. The Director of the Department of Planning and Budget is authorized to transfer the additional appropriation in this provision to Item 109 such that an aggregate appropriation of $15,000,000 will be available in Item 109 from the general fund in the second year for such competitive incentive grants to qualifying regions.

c. An appropriation of $2,000,000 for each year of the biennium from the general fund to provide for rent and operating support for Commonwealth Center for Advanced Manufacturing. The Director of the Department of Planning and Budget is authorized to transfer this appropriation to Item 125 so that this additional funding can be paid to support the Commonwealth Center for Advanced Manufacturing.

d. An appropriation of $16,000,000 from the general fund in the first year to establish multiple higher education research memberships at the Global Genomics and Bioinformation Research Institute. Out of this appropriation, an amount, not to exceed $4,000,000, shall be transferred to each member institution by the Director of the Department of Planning and Budget upon approval by the Governor of a memorandum of agreement between the Global Genomics and Bioinformation Research Institute and each member institutions of higher education specifically stating how the membership funding will be used to further research and collaboration at the Global Genomics and Bioinformation Research Institute. It is anticipated that the appropriation in this provision will support the initial establishment of at least 4 memberships for the public institutions of higher education in the Commonwealth at the Global Genomics and Research Institute over the course of the biennium.

e. An appropriation of $5,500,000 from the general fund in the first year and $3,000,000 from the general fund in the second year to provide support for the Massey Cancer Center at Virginia Commonwealth University. The Director of the Department of Planning and Budget is authorized to transfer this appropriation to Item 209 so that this additional funding can be used to support cancer research.

f. An appropriation of $1,500,000 in each year of the biennium from the general fund for the Jamestown-Yorktown Foundation to help plan, develop, and leverage partnerships for the “2019 Commemoration” celebrating the themes of democracy, diversity, and entrepreneurialism associated with the historic events that took place in Virginia in 1619. The Director of the Department of Planning and Budget is authorized to transfer this appropriation to Item 238 so that this additional funding can be used for this purpose.

g. An appropriation of $3,071,815 the first year and $3,686,254 the second year from the general fund to allow the Department of Social Services to continue to use the Unisys mainframe computer system during the biennium to assist in the implementation of expanded health care coverage for the newly eligible individuals to be served by the Medicaid Program pursuant to the Patient Protection and Affordable Care Act. The Director of the Department of Planning and Budget is authorized to transfer this appropriation to Item 350 so that this additional funding can be used by the Department of Social Services for this purpose.

2. The additional general fund cost to the Commonwealth for expanding health care coverage under the Medicaid Program to the newly eligible individuals pursuant to the Patient Protection and Affordable Care Act is estimated to be $32,151,611 the first year and $162,808,760 the second year. These costs have been addressed by appropriations included elsewhere in the Act.

D.1. In order to recover the non-federal costs to the Commonwealth as specified in C.2. above and allow Medicaid expansion to be implemented and financed solely by private providers, the Department of Medical Assistance Services (DMAS) shall have the authority to require payment of an assessment on private acute care hospitals operating in Virginia. For the purposes of this assessment, the definition of private acute care hospitals shall exclude public hospitals, freestanding psychiatric and rehabilitation hospitals, freestanding children's hospitals, long-term acute care hospitals and critical access hospitals. The department, in collaboration with impacted hospital stakeholders, shall develop the necessary assessment methodology; however, the assessment amount shall not exceed 3.0 percent of a hospital's annual net patient revenue. The provisions of this paragraph are contingent upon approval by the Centers for Medicare and Medicaid Services.

2. The Department of Medical Assistance Services (DMAS) shall collect and deposit any amounts collected from the provider assessment, authorized in D.1. above, into the Virginia Health Care Fund. Such funds shall be accounted for separately within the Fund and reserved for 1) the non-federal share of future Medicaid costs such that the provisions of the Patient Protection and Affordable Care Act can be accomplished at no additional general fund cost to the Commonwealth; 2) increased payments to hospitals, including rural hospitals; 3) graduate medical education; and 4) the cost of administering the assessment.