Traverse City Record-Eagle

September 11, 2013

Medicaid expansion to help many area residents

BY ANNE STANTON astanton@record-eagle.com
Traverse City Record-Eagle

---- — TRAVERSE CITY — Amy Bauer works as a full-time waitress, but insurance isn’t part of her compensation package.

Bauer wasn’t immediately aware that Michigan lawmakers just passed expansion of Medicaid insurance, but definitely is interested in signing up.

“If I could qualify, you betcha,” said Bauer as she shopped for clothes at Goodwill Industries retail store. “That would be helpful. My husband doesn’t have insurance either, but our kids do. When you get sick, you just hope it will pass because you don’t want to pay money.”

Medicaid already covers one in five Michigan residents, mainly low-income children, pregnant women, and the disabled. But poor working adults rarely qualify. The program, to take effect in April, will assist nearly 500,000 state residents who earn 133 percent of the federal poverty guidelines or less — a family of four, for example, making up to $31,322.

A total of 10,314 additional folks in Antrim, Benzie, Leelanau, Kalkaska, and Grand Traverse counties would be eligible for Medicaid under the expansion, according to the Michigan Department of Community Health.

The move received a thumbs-up from other Goodwill shoppers.

“I think it’s good,” said Sally Troyer of Traverse City. “I’m real sad right now about people whose hours were cut less than 30 hours so employers won’t have to pay insurance. The people are barely making money as it is.”

Troyer was referring to the Affordable Care Act’s upcoming mandate to provide health insurance to those who work 30 hours or more.

Lawmakers from northern Michigan gave a mixed vote. State Sen. Howard Walker’s vote was pivotal in the final 20-18 Senate tally. State Rep. Wayne Schmidt, R-Traverse City Republican, also voted yes.

“This way, we make sure people have access to affordable healthcare that doesn’t make use of expensive fixes, such as the emergency room,” Schmidt said.

Schmidt said the bipartisan agreement inserted elements of personal responsibility. The bill requires the additional recipients to contribute 5 percent of their out-of-pocket medical costs. After 48 months, that co-pay would increase to 7% or recipients could opt to buy insurance on the health care exchange.

“If they have a healthier lifestyle, quit smoking or lose weight, the incentives are there too. It wasn’t a simple solution,” Schmidt said.

Walker, R-Traverse City, said it wasn’t an easy decision, but the pluses outweighed the minuses.

“Most of the folks who qualify are the working poor and are out there trying to move forward, doing the right thing,” Walker said.

Rep. Greg McMaster, R-Kewadin, first voted in favor of Medicaid expansion in June but flipped to “no” on last week’s vote.

“I knew it needed extra work (in June). So when it went through the Senate, I put in an amendment that said it would sever all ties with Obama Care and the health care exchange because we didn’t have a solid system in place,” said McMaster, whose 35th District includes Antrim County.

McMaster said his amendment didn’t go through. That, along with federal funding and implementation difficulties, led to his no vote.

Darwin Booher, R-Evart, and Rep. Ray Franz, R-Onekama, also voted no.

Greg Paffhouse, executive director of Northern Lakes Community Mental Health, applauded the vote.

About half the agency’s adult psychiatric clients lack insurance; the state’s Mental Health Code requires CMH to serve the most impaired first, he said.

“Those that have conditions, not as severe, go on a waiting list,” he said, adding some can’t find services anywhere.

It’s also an “absolute positive” for the Traverse Health Clinic and its clients, said Arlene Brennan, executive director.

Billboards across town predicted the clinic’s demise unless it received an infusion of money. The clinic anticipated a $1 million loss in 2014 because of the health care reform. This expansion will restore most of that loss, she said.

Between 40 to 45 percent of the clinic’s patients will now get medical coverage, but there remain plenty of unknowns, she said.

“We aren’t sure yet what this means for access to specialty care in the community,” she said.