Medicaid expansion clears state legislature, but enactment will likely be delayed

Michigan Public Radio Network

State lawmakers have approved expanding Medicaid to hundreds of thousands of low-income workers in Michigan. The state House gave the bill final legislative approval Tuesday.

The measure would extend coverage to nearly half-a-million people through the federal Affordable Care Act by the end of 2015.

House Speaker Jase Bolger applauded both Republican and Democratic lawmakers who supported the bill.

“We have provided additional coverage for hundreds of thousands of additional Michiganders today,” said Bolger. “We are looking out for their health care. We’ve also provided significant protection for Michigan’s taxpayers today. Today is a good day.”

But the state Senate blocked a measure that would allow the expansion to take effect at the beginning of next year. That means more than 300-thousand low-income residents may have to wait until late March or April to be eligible for Medicaid.

Supporters like House Democratic Leader Tim Greimel had hoped the expansion would kick in on January 1st.

“The cowardice of Senate Republicans in opposing immediate effect will cost our state over 600 million dollars in federal funding,” Greimel told reporters Tuesday after the final House vote.

“That’s money that would otherwise go to making sure that those working poor in our state get their health care coverage they need sooner. And it would also go to bolster our general fund. Our general fund is going to lose tens-of-millions of dollars that it would otherwise get as a result of the Senate’s delayed action.”

But Senate Majority Leader Randy Richardville said it was time to move on.

“It’s my opinion that the votes were already cast, there wasn’t anybody planning to change their mind,’ Richardville said, “so let’s just go ahead and send the bill over to the House.”

There is also some question over what the delay will mean for people at 133 percent of the federal poverty line who are eligible to be part of the expanded Medicaid program. The delay in coverage could subject them to fines under the federal Affordable Care Act. But state officials say the IRS may forgive the fines for people who enroll.

Governor Rick Snyder cheered the news of the approval, even though he was disappointed that the coverage won’t begin before early spring. Snyder says he looks forward to singing the bill when he returns from a 10-day trade mission to China and Japan. He delayed his departure to follow the Medicaid vote.

“Hundreds of thousands of Michiganders will have an opportunity for healthcare coverage,” he said. “It’s a situation that will also save all Michiganders money in terms of addressing an unmanaged, uncontrolled system with a managed system that emphasizes personal responsibility, wellness, and managed care.

“So this is a bright day in Michigan. I’m looking forward to moving forward.”

The next steps are for the state to design a publicity campaign to encourage eligible people to enroll in the program.

The Legislature voted to require working poor people on Medicaid to have healthcare savings accounts. The measure also calls for incentives for people to adopt healthy behaviors. Those both require approval by the federal government.

“The federal government really wants Michigan to be part of this, and I think they’re going to move this waiver along as fast as they can,” said Michigan Department of Community Health Director James Haveman. “They have certain benchmarks and timelines that they have to follow, but they’re partnering with us on this.”

The federal government has a target of signing up 66 million people for the expanded Medicaid program. Michigan has a target of 360 thousand working poor people for the sign-up period that ends March 31st.

Copyright 2013, MPRN