Friday, June 14, 2013

State House Passes Medicaid Expansion - from the Detroit News

Lansing — Legislation to extend Medicaid health coverage to as many as 470,000 Michiganians passed 76-31 in the state House late Thursday.

The controversial bill, unpopular among many Republicans, broadens the federal health insurance program for the poor to include adults with incomes up to 133 percent of the poverty level, or $15,281 a year for an individual.

It heads to the GOP-led Senate, where it will face its final, and possibly toughest, hurdle before it can go to Gov. Rick Snyder for his signature.

Thursday’s vote, which spared Snyder a defeat from his own party, was delayed late into the evening as House Republicans sought assurance the Senate GOP caucus would back them up if they approved the bill. Republican lawmakers are under heavy pressure from tea party and other conservative groups that have threatened to withdraw political support from lawmakers who vote for the measure.

Snyder lauded the passage Thursday, saying it would “reform and strengthen the state’s Medicaid program.”

“This is a Michigan plan for Michigan families, communities, businesses, and our economy,” he said. “It will help to curb skyrocketing medical costs by encouraging wellness, healthy behaviors and personal responsibility, reduce the burden of uncompensated care that shifts costs onto businesses and taxpayers, and help our citizens access affordable care.”

The measure passed with 28 Republicans joining all but one Democrat.

Michigan is among a number of states on the fence about Medicaid expansion. Those states are under pressure to decide the issue before federally mandated state health insurance exchanges are required to start operating Oct. 1.

The bill needs 20 votes to pass in the Senate — or 19, plus the lieutenant governor’s tie-breaking vote.But even if all 12 Democrats vote for the bill, it would need the support of at least seven Republicans.

Rep. Mike Shirkey, R-Clarklake, who pushed the bill through, urged his caucus to support it. “There are perfectly good legitimate reasons to oppose” but “sound, reasonable reasons to support” it, he said.

“I believe it’s time to stop playing defense on something that’s the law of the land and begin playing offense,” Shirkey said.

Democrats lauded the bill as a bipartisan effort. Rep. Scott Dianda of Calumet was the sole Democrat to vote no.

As few as six Senate Republicans were believed to support the Medicaid expansion as of Wednesday, but Shirkey, who chaired the House committee that shaped bill, said the number grew as senators learned details of the legislation.

“I will do my best to ensure that the passage is limited to the House,” said Sen. Patrick Colbeck, R-Canton Township, late Thursday on his Facebook page.

Even after passage, the bill would face another hurdle from the federal government, which would have to agree to Michigan’s requirement that able-bodied adults with incomes between 100 percent and 133 percent of the poverty level contribute up to 5 percent of their income to their health care. Another federal waiver would be needed to require the contribution be raised to 7 percent after four years in the program.

Snyder announced his support for the massive federally funded expansion of the Medicaid health insurance program for the poor in February, joining a cadre of Republican governors who broke party lines to support a key component of “Obamacare.” A coalition of tea party groups Tuesday issued an open letter calling on conservatives to withdraw support for Snyder’s re-election bid.

Many Republicans have said they don’t trust the government’s promise to pay for the program; others have vowed not to implement the Affordable Care Act, saying that it would amount to tacit approval of “Obamacare.”

Some House Democrats objected to a requirement beneficiaries contribute part of their income to their health care.

Under the Affordable Care Act of 2010, the federal government has committed to funding the Medicaid expansion, estimated at $2 billion annually for Michigan, and save the state $200 million annually. Starting in 2017, the state would start picking up part of the costs, reaching a total contribution of 10 percent in 2020.

Snyder has proposed putting half the $200 million annual savings into a fund for later years “to offset those costs when the state has to start paying.”


From The Detroit News: http://www.detroitnews.com/article/20130614/BIZ/306130140#ixzz2WCWU9Ybd

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