April 2023


On Saturday, February 25 the Virginia House of Delegates and the Senate of Virginia adjourned sine die after completing much of the legislative work on the docket for the 2023 regular legislative session. Nearly 2,000 pieces of legislation were introduced in both chambers of the General Assembly. Of that total, 819 bills were sent to Governor Glenn Youngkin for his signature or veto. For most bills, the Governor had 30 days to act on legislation passed close to the legislature’s date of adjournment. In all, he signed 739 bills, vetoed three bills, and recommended amendments to 78 bills including House Bill 1400 – the budget bill. Lawmakers have not yet reached a compromise on the budget legislation so more negotiations between Democrats and Republicans are anticipated on the budget legislation prior to July 1, the date when many new laws take effect and when the state’s new fiscal year begins. In the meantime, the General Assembly reconvened on April 12 to act on the Governor’s vetoes and recommendations. VHHA and its members worked with legislators and other stakeholders throughout the legislative session on a variety of health care issues that are critical for Virginia hospitals and health systems.

The end of session also marked the end of the legislative careers of at least 23 members of the House and the Senate due to retirements by many veteran sitting legislators. Those departures equate to the loss of more than 500 combined years of institutional knowledge and experience leaving the General Assembly. The end of session also sets the stage for a busy election season. 

–The VHHA Government Affairs Team

What’s Happening in Richmond

The 2023 General Assembly Session 

This year’s General Assembly session was highlighted by partisanship and traditional election year issues such as: abortion, education, and gun rights. However, health care issues remained top-of-mind for many legislators. There were several measures concerning hospital price transparency. Delegates Nick Frietas (R-Culpepper) and Dan Helmer (D-Fairfax) co-sponsored legislation (HB 2427) that would allow patients or third-party groups to bring a private right-of-action against hospitals that are not in “material compliance” with federal or state price transparency regulations. Delegate Keith Hodges (R-Middlesex) introduced HB 2435 that would have u nnecessarily driven up health care costs and increased financial burdens on the state, patients and hospitals. VHHA, its members, and the Virginia Chamber of Commerce strongly opposed both bills. After making it through the House Committee on Health, Welfare, and Institutions, both proposals were defeated on the House floor by a bipartisan vote.

In response to increased violence in health care settings, legislators introduced legislative solutions to address this growing concern. Senator Favola’s (D-Arlington) legislation (SB 827) requires a certain level of security in all emergency departments in the Commonwealth. VHHA worked with Senator Favola and other stakeholders to achieve favorable amendments that ensure any requirements are not a burden for health care providers. Delegate Bell (R-Albemarle) HB1835 that removes the location element of the law that imposes an additional penalty to those who make oral threats against health care providers, thereby expanding it to all health care setting. Both bills were signed by the Governor.

Legislators also introduced efforts to deregulate and dramatically alter Virginia’s certificate of public need (COPN) program. Legislation from Delegate Robinson (R-Chesterfield) and Senator Peterson (D-Fairfax City) (HB 1600/SB 953) would have allowed profitable services such as imaging, ambulatory surgery, and single specialty practice operating rooms to “skip the line” through the COPN process, threatening the financial viability of important services at acute care hospitals in the Commonwealth. VHHA strongly opposed both bills and they were each defeated in their respective committees. Delegate Byron (R-Bedford) also filed a bill (HB 2279) that would have considered Medicaid to be charity care for purposes of meeting charity care conditions for any certificate holder that is not a hospital. The Delegate struck her bill before it was heard in committee. 

In response to stories from the national press and interest from various patient advocacy groups, Delegate Tran (D-Fairfax County) filed legislation (HB2472) regarding the federal 340B drug pricing program. Her bill would have required Virginia Health Information (VHI) to create a reporting process for 340B hospitals to report certain data to the state. 340B is a federal program and is sufficiently supervised by federal regulators. The bill was defeated in a subcommittee of the House Committee on Health, Welfare, and Institutions.

Reforming Virginia’s behavioral health system remained a central focus for legislators on both sides of the political spectrum. At the request of VHHA and Riverside Health System, Senator Monty Mason (D-Williamsburg) proposed legislation to allow qualified physicians working in psychiatric emergency departments to conduct the temporary detention order (TDO) evaluation. If adopted, the measure would have alleviated much of the backlog in ensuring that patients can receive the behavioral health care that they need. The bill was defeated in a subcommittee of the House Committee on Courts of Justice with the understanding that a letter would be sent to the Behavioral Health Commission to prompt further study.

2023 Races to Watch

2023 is an election year in Virginia. Each of the 140 seats in the Virginia General Assembly will be on the ballot. Following a wave of retirements and new legislative districts created by the Supreme Court of Virginia, the political landscape in the Commonwealth is changing rapidly. With new districts, many races will be determined by the winner of a contentious nomination processes, while a few competitive general election contests could determine which party controls the House of Delegates and the Senate of Virginia. Over the next couple of months, VHHA will highlight some of the marque races that will be critical in determining the future of the Virginia General Assembly. To find out which races and candidates will impact your community follow this link:

Senate District 22 (Prince William County) – Hala Ayala vs. Jennifer Carroll Foy

Following the redistricting process, a new Senate district was created to include parts of Prince William and Fairfax counties. Both candidates for the Democratic nomination are former members of the Virginia House of Delegates and candidates for statewide office. In 2021, Delegate Carroll Foy unsuccessfully sought the Democratic nomination for Governor. Delegate Ayala was the Democratic nominee for Lt. Governor. District 22 is a traditionally Democratic area. The winner of the primary will most likely join the Senate of Virginia in January 2024.

House District 47 (Carroll County) – Delegate Wren Williams vs. Delegate Marie March

The only race that includes two incumbent members of the House of Delegates is the 47th House district. Republican Delegates Wren Williams and Marie March were first elected in 2021. Both candidates are self-described conservatives. This competitive primary will also most likely determine the district’s representative in the House of Delegates.

What’s Happening in Washington, D.C.

Congressional Hearing Regarding “Transparency and Competition” in Health Care

On March 28, the Health Subcommittee of the House Committee on Energy and Commerce met to discuss transparency and competition in health care. Much of the conversation was driven by the agenda of third-party advocacy groups seeking to profit from patient and hospital data. Witnesses provided very misleading testimony to members of the committee. VHHA and other state hospital associations are preparing for more hearings and potentially harmful legislation to be filed in the U.S. House of Representatives.

VHHA is working with the Virginia congressional delegation and the American Hospital Association to combat these misleading narratives and promote the value of hospitals in communities across the Commonwealth.

Engage with VHHA & HosPAC

Join the Hospital Grassroots Network!

Sign up for the VHHA Hospital Grassroots Network to join our rapid response network that helps legislators understand the importance of a pending health care vote or issue.

The Virginia Hospital Advocate newsletter will also help keep you updated on key issues so that you’re informed and ready to respond when an urgent action alert is issued.

Register online today!

Support Dedicated Legislators through HosPAC!

HosPAC is VHHA’s political action committee. HosPAC provides organized, effective political action by supporting candidates who will work to improve quality health care through policies that recognize the importance of Virginia’s hospital and health systems.

To contribute,
please visit

HosPAC participation is strictly voluntary and not tax deductible.

Thank you for supporting Virginia hospitals!

VHHA’s Advocacy Team works hard to keep you up to date with the latest health care policy and politics news. We love to hear from our members and supporters!

Please don’t hesitate to contact members of the team, and send Davis feedback or suggestions for topics to cover in future newsletters. Thank you!