It’s just another end-run around Obamacare that’s almost certain to fail — and could drag Medicaid expansion down with it.
Don’t let the Michigan House GOP fool you. They don’t really want Medicaid expansion in Michigan. They just want you to think they do.
As reported in the Detroit News, legislation introduced by the House GOP on Thursday would require Michigan to get a waiver from the federal Centers for Medicare and Medicaid Services (CMS) to allow a 48-month lifetime limit on taxpayer-funded medical insurance for non-disabled adults. That cap on benefits is the centerpiece of their “counter-offer” to Governor Rick Snyder’s proposal to expand Medicaid, although they also expect low-income families to pay five percent of their annual income in premiums.
That’s astounding, given that many people eligible for Medicaid struggle just to buy food. Not to mention that, as I’ve written here before, Medicaid expansion is funded 100 percent by the federal government through 2016, a figure that drops incrementally to 90 percent by 2020, where it stays. That means a majority of Medicaid expansion is paid in full. The rest is covered by taxes citizens already pay to the federal government. No one is being asked to pay more. In fact, the state of Michigan stands to bring in about $2.1 billion through economic activity created by Medicaid expansion.
So not only do the House Republicans not understand math, they also don’t appear to understand Medicaid expansion. And, apparently, don’t have an ounce of compassion.
Here’s what House Speaker Jase Bolger (R-Marshall) had to say, as quoted in the Detroit News:
It goes entirely to our belief that government assistance is not an entitlement, nor is it a lifestyle, if you’re an able-bodied adult.”
House Republicans claim their proposal would exempt children, the disabled and the elderly. But they’re using the vaguest possible terms. What qualifies someone as an “able-bodied adult”? Does a man with asthma receive only four years of Medicaid because he can walk? Does a woman have to bear all the children she plans to raise in four years or miss out on essential prenatal care services? Do people with cancer have to stop getting treatments when their four years are up? Health conditions like epilepsy, heart disease, arthritis and countless others don’t just disappear in four years.
The Affordable Care Act, a.k.a. Obamacare, explicitly states that insurers can’t cap benefits, so it’s unlikely CMS will agree to the Michigan House GOP’s proposal. I suspect Michigan Republicans know that full well, but are simply stalling and spinning, to look as if they’re trying to work with the Governor, Democrats, healthcare providers and citizens who support Medicaid expansion.
Speaker Bolger claims these caps are modeled after other “welfare” programs such as food stamps or housing assistance. But how can you put a limit on someone’s health? The answer is you can’t.
Michigan Democrats have called the proposal “shameful.” Here’s what Rep. Jim Townsend (D-Royal Oak), had to say, in the Detroit News piece:
Kicking [people] off the program after four years is immoral. Health care costs are going to rise as soon as these people who have been getting care lose their insurance and have to head back to the ER.
According to a report in Crain’s Detroit Business, House Republicans claim that when four years are up, people on Medicaid will all have jobs and be able to afford private health insurance. But considering the Michigan legislature’s woeful track record on job creation in recent years, that’s a ridiculous excuse. Unless the House GOP can promise those people jobs with benefits or ample salaries, why on earth would they refuse federal funding that provides Michiganders with health insurance?
House Democratic Leader Tim Greimel (D-Auburn Hills) addressed the point emphatically in a press release:
This plan is a slap in the face to anyone in desperate need of health care who had hoped our state would do the reasonable thing and accept federal funds to expand Medicaid. We should have done the responsible thing and accepted federal funds to pay for Medicaid expansion, bringing health care to 400,000 Michigan residents who currently have none. Instead, Republicans want some of our most struggling families to pay 5 percent of their annual income to get limited access to health care for a short time only — while insisting the state never contribute a single penny to the program Republicans proposed. It’s heartless, irresponsible and an insult to the people of Michigan.
Governor Snyder and supporters of Medicaid expansion have said they are willing to work with the legislature to find a compromise that meets federal law. I applaud their continued efforts to make Medicaid expansion happen. I’m just not convinced Michigan Republicans share their commitment.
Speaker Bolger claims this proposal is a first step in Medicaid reform. That’s all well and good, but that’s not the issue currently on the table. Accepting Medicaid expansion needs to happen now or hundreds of thousands of Michiganders will remain uninsured, creating a financial drain on our hospitals and costing those who do buy insurance more money in the long run.
If House Republicans want to propose Medicaid reform, fine. But tying it to Medicaid expansion will achieve nothing but slowing down, if not preventing, Medicaid expansion in Michigan — at the expense of everyone and everything but the GOP’s continued efforts to thwart Obamacare every chance they get.
[Poisoncare sign photo by Chris Savage | Eclectablog]