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Published: Friday, 11/8/2013

Michigan asks Obama administration for approval of Medicaid expansion plan

ASSOCIATED PRESS

LANSING, Mich. — Gov. Rick Snyder today asked the Obama administration to sign off on Michigan’s Medicaid expansion plan, one that needs approval because it differs from the basic option offered to states under the federal health care law.

The expansion signed into law by the Republican governor in September establishes individual health savings accounts for adult recipients and requires them to pay up to 5 percent of their annual income toward the government health insurance program that Michigan runs through managed-care plans. Monthly premiums and copays can be reduced if participants engage in healthy behaviors — starting with completing a yearly health-risk assessment to identify smokers, substance abusers and those who are overweight or not up to date on vaccinations.

“We don’t see any show-stopper here,” state Department of Community Health Director Jim Haveman told The Associated Press. He said state officials have had weekly conference calls with federal officials to prepare the request and he expects their endorsement by year’s end, “hopefully by the middle of December.”

“This really is a Michigan-designed plan with a lot of input from the House and Senate and administration,” Haveman said. “There’s not another bill like this in the country.”

Medicaid already covers one in five Michigan residents, mainly low-income children, pregnant women, the disabled and some poorer working adults. Starting April 1, the expansion will cover adults making up to 133 percent of the poverty line — $15,500 for an individual, $26,500 for a family of three. Michigan now covers childless adults earning up to 35 percent of the poverty level.

Haveman said he expects 320,000 uninsured adults to enroll in 2014. Of those, about 70,000 will fall between 100 and 133 of the poverty level and be subject to premium requirements.

“This adds those adults who are really the working poor who don’t have health coverage,” Haveman said.

Adults making 100 to 133 percent of the poverty line can also buy insurance on the federal health exchange with the help of tax subsidies, though Haveman said the “Healthy Michigan” Medicaid program will offer extra mental health benefits, dental coverage and hearing aids.

Copays for newly eligible participants are the same as for current Medicaid recipients — $2 for an office visit, $1 per generic prescription drug and $3 for an emergency room visit that is not an emergency. In accordance with federal rules, no copays will be required for preventive services, emergencies and emergency hospital admissions.

Snyder, who pushed hard to win passage of the plan in a Republican-controlled Legislature resistant to the federal health care law, said Michigan is another step closer to having a “healthier, more productive workforce.”

Medicaid expansion is part of a strategy to ensure that nearly all Americans have health insurance under the Affordable Care Act. It was designed to cover the neediest uninsured people yet became optional for states because of a Supreme Court decision.

Michigan is one of 25 states along with Washington, D.C., to embrace Medicaid expansion. The latest to do so was Ohio, where a lawsuit has been filed by Republican lawmakers and anti-abortion groups because a legislative panel approved expansion funding but not the full Legislature.



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