Traverse City Record-Eagle

Michigan

August 26, 2013

Big Medicaid expansion vote looms in Mich. Senate

LANSING, Mich. (AP) — Two months after putting off a decision on whether to expand Medicaid to more low-income adults, leaders of the Michigan Senate are looking to hold their much-anticipated vote.

The showdown in the Republican-dominated chamber on Tuesday or Wednesday could determine whether hundreds of thousands of state residents will qualify for government-provided health care starting in January.

Here’s a look at the issue and dynamics at play:

WHAT IS MEDICAID EXPANSION?

The 2010 federal health care law has a two-part strategy to ensure nearly all Americans have health insurance. One is Medicaid expansion, which was designed to cover the neediest uninsured people but became optional for states because of a Supreme Court decision last year.

Medicaid already covers 1.9 million, or one in five, Michigan residents — mainly low-income children, pregnant women, the disabled and some poorer working adults. The debate is whether to cover nearly a half-million more adults making up to 133 percent of the poverty level, or $15,500 for an individual and $26,500 for a family of three.

WHY LIKE IT?

Republican Gov. Rick Snyder is lobbying for the expansion along with the medical and insurance industries, Democrats, some GOP lawmakers and advocates for the poor. Snyder says those who would be covered now use the emergency room for medical care — which he says is unacceptable, expensive and leads to higher premiums for businesses and individuals with private insurance. Reducing those ER visits by giving people an insurance card to go to the doctor will save money, according to proponents.

The expansion is fully financed by the federal government for the first three years and phases down gradually to a 90 percent federal share. The state would save money initially but owe later on. Cumulative costs would exceed savings in 15 years, according to the nonpartisan Senate Fiscal Agency. Snyder also says the Affordable Care Act is here to say, so Michigan might as well get something in return for the new taxes coming under the law.

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