Michigan Likely To Decide Medicaid Expansion This Week

After delaying action earlier this year, Michigan lawmakers are expected this week to take a historic vote on expanding Medicaid expansion as part of the Affordable Care Act.

The Michigan House of Representatives voted by a wide majority earlier this year to approve HB 4714, which would lower income eligibility to 138% of the federal poverty level and expand coverage to as many as 450,000 state residents.

Expanding Medicaid would cost about $1.7 billion a year, although 100% of that total would be paid by the federal government from the start of 2014 through 2016. The state would make a 10% contribution in intervening years.

However, the Senate took a long recess earlier this summer before voting on the bill. Although Gov. Rick Snyder, a Republican, supports expanding Medicaid and there are apparently enough Republican votes in the 38-member Senate to pass the measure with Democratic support. But Senate Majority Leader Randy Richardville had objected to taking a vote on the bill unless the majority of the 26 GOP lawmakers supported it. Senate Democratic Leader Gretchen Whitmer of East Lansing said her entire 12-member caucus will vote for the bill.

Snyder has been visiting Republican lawmakers in their districts over the summer to drum up support for the legislation. He noted that healthcare costs would continue to rise without expanding Medicaid, and that many low-income Michiganders would not be able to afford to buy insurance through the state's health insurance exchange. Although he apparently has not change any minds, recent published reports suggest Richardville may be willing to take a vote.

“We are confident there are votes on the floor to pass this,” said Roger Martin, spokesman for Expand Medicaid, a coalition of providers and businesses that support the bill.

Two alternative bills have also been floated, one of which would place a 48-month lifetime cap on Medicaid benefits and have fairly steep deductibles and co-payments. Another bill would allow low-income Michiganders to purchase primary care coverage through health savings accounts. Snyder has said he does not support either bill. It is unknown if they will come up for a vote this week.