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Delegate Sam Rasoul (D-Roanoke) took to the floor of the Virginia House of Delegates today to oppose the imposition of workfare across the board for Medicaid recipients, a feature of the Republican-brokered health care expansion package that would require every able-bodied person accepting Medicaid to seek employment… or lose their taxpayer handout.

What is clear now is that the reform package that blends the best of the Indiana block grants passed by then-Governor Mike Pence with the work requirements included by Kentucky Governor Matt Bevin has finally dawned on Democrat insurgents on the progressive left — with a handful now refusing to support the conservative form of expanding healthcare.

The plan will impose a work requirement which forces recipients to work if they are able bodied before receiving any benefits. The new plan also says if a person goes three months with out working, they will be locked out of coverage.

Of course, this confounds Democratic aspirations to simply put more people on a government-subsidized plan by introducing reforms similar to the workfare requirements brokered by U.S. Speaker Newt Gingrich with welfare reform back in 1995.

With Democrats on the verge of open revolt, all eyes turn on the Virginia Senate, where State Senator Emmett Hanger (R-Augusta) is signalling openness to the House budget provided hospitals are not taxed indiscriminately to the point of passing costs down to the consumer.

As it stands now, the sticking point of “who pays” and “how” are the two hurdles yet to be cleared.  Treating Virginia’s already hard pressed hospitals like a statewide piggy bank akin to the Virginia Lottery system — where 50% of every dollar was supposed to go to education — is now the sticking point.

Should hospitals be able to manage their own costs and reimbursement for healthcare expansion, a compromise is most certainly in sight.  Linked to conservative reforms that prioritize work requirements?  We might have a one-two punch of closing the coverage gap and increasing labor force participation across the entire system — the very definition of compromise.

While Democrats privately seethe at workfare requirements across Medicaid, the very real possibility of closing the coverage gap while reforming entitlements is there.