Traverse City Record-Eagle

Michigan

September 1, 2013

Medicaid debate turns to when expansion occurs

LANSING, Mich. (AP) — The Michigan Senate's intense, months-long debate over Medicaid expansion and the federal health care law is not over, even after the Republican-controlled chamber's milestone vote to provide health insurance to hundreds of thousands of low-income residents.

Senators on Tuesday will reconsider the issue of when the legislation should take effect. While the Senate passed the bill 20-18 in dramatic fashion, it fell two votes short of the 26 needed for immediate effect.

For an estimated 320,000 newly eligible adults counting on the medical coverage next year, it means waiting until late March or early April instead of qualifying as early as Jan. 1. It also could cost the state — which is taking the U.S. government's offer to pay the entire cost of expansion for the first three years — $64 million in savings primarily associated with paying mental health and substance abuse treatment costs with federal dollars.

Republican Gov. Rick Snyder, for whom Medicaid expansion is a major legislative priority, said he hopes that when the "dust all settles" after last Tuesday's vote, more Republicans will agree to let the bill go into effect in January even if they voted against the measure itself.

Four Republicans of the 18 voting "no" did that.

"Should we make people wait three more months for the opportunity to get this coverage? I'm not sure the benefit of the three-month wait," Snyder said.

Since winning a supermajority in 2010, Senate Republicans typically have been united in letting proposed laws have effect immediately when such votes are held. The votes are seen as "procedural" and a chance to stick together when passing bills along party lines over Democrats' objections.

Every GOP senator agreed in December to put contentious emergency manager legislation into law immediately even though some Republicans voted against the bill. The law ultimately took effect in March because the House did not grant it immediate effect.

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