Michigan, Ohio Stall On Medicaid Expansion

The expansion of the Medicaid program in two of the Midwest's most populous states by the start of 2014 is becoming increasingly unlikely.

The GOP-controlled Michigan Senate did not vote on a Medicaid expansion bill before Majority Leader Randy Richardville voted to adjourn for the summer last week.

Although the House had passed an expansion bill by a wide majority on June 13 and there was similar solid bipartisan support in the Senate, Richardville did not want a vote cast unless a majority of Republicans were in favor of expansion. Twenty-eight of 30 House Republicans who voted did so in favor of expansion.

The inaction in the Senate left Gov. Rick Snyder, a moderate Republican who supports Medicaid expansion, frustrated with the legislative process.

“Why does the Michigan Constitution say we have 38 senators?” Snyder asked. “Shouldn’t the constitution say once a party wins the majority of a chamber, why do you even bother having the other people show up? It doesn’t say that.”

However, Snyder has been hedging as to whether he will call a special session of the Legislature, as Democratic lawmakers have requested.

Medicaid expansion in Michigan would cover another 400,000 of the state's residents.

In Ohio, lawmakers have indicated they have no plans to place Medicaid expansion in its most recent two-year budget, even though it has the support of Gov. John Kasich, another Republican.

Ohio's House Speaker, William Batchelder, a Republican, said last week a vote might take place in late August. Officials in Kasich's administration have said that would be cutting it too short.

“We need six months. It’s a combination of our own administrative work, work with the feds, just giving people time to enroll,” Eric Poklar, spokesman for the Governor’s Office of Health Transformation, told the Cincinnati Enquirer. “If they wait 55 days to pass a bill, we will not have this up and running Jan. 1. Period.”

In Ohio, about 360,000 residents would be eligible for coverage under the Affordable Care Act, which relaxes income eligibility to 138 percent of the federal poverty level. The federal government has agreed to pay for 100% of the expansion between 2014 and the end of 2016, and 90% after that.

As in Michigan, the votes are available to pass, comprised of virtually all Democrats and a minority of Republicans. But Ohio's GOP leaders don't want a vote unless a majority of their caucus supports the expansion.