Medicaid growth gets final OK in Michigan House

Health coverage expected for 320,000 by late March


LANSING — Michigan lawmakers gave final approval Tuesday to a measure that would make more low-income adults eligible for Medicaid, positioning the state to become the largest controlled by Republicans to support a key component of the new federal health care law.

In a bipartisan 75-32 vote, the House approved expanding the government health insurance program to almost a half-million Michigan residents within a few years, nearly halving the state’s uninsured. An estimated 320,000 are expected to be eligible in late March if the federal government OKs the plan.

State senators approved the bill last week on the narrowest of possible margins, a 20-18 vote.

Gov. Rick Snyder broke with other Republican governors this year to support a Medicaid expansion he said would save taxpayers and businesses money while improving the quality of life for Michigan residents currently not covered.

Mr. Snyder is expected to sign the measure after returning from a 10-day trade trip to Asia. The bill would then take effect 90 days after the current session ends in December. The Senate vote on whether to give it immediate effect fell two votes shy of the needed two-thirds majority.

“I would have preferred to have gotten immediate effect, but what I would say is this is still a victory for Michiganders — both in terms of the people getting coverage and all Michiganders,” Mr. Snyder said.

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

Many GOP-led states opposed to “Obamacare” have declined the expansion, despite the U.S. government promising to cover the entire cost for the first three years and 90 percent later. Michigan is poised to become the seventh state led by a Republican governor to expand Medicaid, and just the third where the GOP also controls the Legislature — joining Arizona and North Dakota.

The program already covers one in five Michigan residents, mainly low-income children, pregnant women, the disabled, and some poorer working adults. The expansion would cover adults making up to 133 percent of the poverty level — $15,500 for an individual, $26,500 for a family of three.

Republican-drawn cost-sharing provisions for 150,000 people making between 100 and 133 percent of the poverty line, along with financial incentives to lead healthy lifestyles and a plan to create individual health savings accounts, still need federal approval.

Mr. Snyder and a large coalition of backers ranging from the business and medical lobbies to advocates for the poor say offering health insurance to more low-income residents will make them healthier and minimize expensive trips to the emergency room, preventing cost-shifting to businesses and individuals with health plans.

Opponents question such a big government expansion when the United States is trillions of dollars in debt and are suspicious of money-saving claims. Tea party and conservative activists plan to oppose Mr. Snyder’s expected re-election bid because of his push to expand Medicaid coverage.

“I’ve been on Medicaid. So have members of my family. It’s not easy and it’s not a great option,” said Rep. Ed McBroom (R., Vulcan), who voted against the bill. “We seem to be focused on the overall numbers and the overall dollars rather than on the quality of care.”

Democrats criticized Republicans for not covering people as soon as possible. The roughly three-month delay could cost the state up to $64 million in savings primarily associated with paying mental health and substance abuse treatment costs with Medicaid funds.