Michigan Medicaid expansion remains stalled in the Senate


Two days of hearings yield a disappointing lack of action.

The Senate Government Operations Committee spent two days hearing testimony on Medicaid expansion and debating three possible paths forward. It voted for all three — which means there will be yet more debate and delay on legislation that could make a life-or-death difference for nearly 500,000 Michiganders.

The committee did vote to approve the Senate substitute to the Medicaid expansion bill already passed by the House. However, they also approved two alternatives that actually don’t expand Medicaid. Instead, those plans offer people who can’t afford health insurance now options for buying health insurance. (It doesn’t make sense to me, either. More on that below.)

Senate Minority Leader Gretchen Whitmer said the continued lack of a vote on the Senate floor was threatening to make it virtually impossible for the state to get the program up and running by January 1, 2014.

The Senate Republicans’ lack of action on this legislation threatens to leave hundreds of thousands of Michigan residents without access to healthcare next year and cost taxpayers millions of dollars for every single day this program is delayed. We took a small step forward today in voting the bill out of committee, but the real test of leadership is to pass the bill on the Senate floor and send it to the Governor’s desk. The Republicans failed that test once again today.

On a conference call I listened in on with the White House today regarding implementation of the Affordable Care Act (the ACA, better known as Obamacare), Michael Hash, director of the Office of Health Reform for the U.S. Department of Health and Human Services, answered a question from a Michigan Radio reporter about the waivers required for Medicaid expansion bills that vary from the ACA’s guidelines. Hash said HHS would do everything possible to reach workable agreements with Michigan and other states seeking waivers.

Even if the waivers are approved, however, state and federal officials have warned that numerous steps must be taken before the program itself can be implemented. With a Senate vote now delayed for another month, Michigan may not meet the implementation target date of January 1, 2014. During the committee hearings, Department of Community Health Director Jim Haveman testified that this delay would cost the state $7 million per day.

Sen. Whitmer addressed the human and economic cost of this delay:

It’s unconscionable that Republicans would continue to jeopardize the health of Michigan’s people as well as that of our state budget simply because they don’t want to acknowledge the positive impacts that the Affordable Care Act can and will have here in our state. The Republicans’ refusal to do their jobs not only denies access to needed care, but could cost taxpayers millions of dollars per day at this point and that is absolutely something the people of Michigan aren’t going to forget anytime soon.

Whitmer also criticized Senate Majority Leader Randy Richardville for voting on two competing “alternative” plans put forward by Tea Party-backed Republicans that officials testified would cost the state at least a billion dollars more than expanding Medicaid and would worsen access to preventative healthcare for low-income Michigan families. Whitmer called the Republican alternatives “unworthy of legitimate debate and simply meant to distract from their own delays in getting real Medicaid expansion legislation passed.”

One of the plans is essentially a voucher program while the other creates a sort of health insurance marketplace where low-income Michiganders could buy insurance. The thing is, the people who could benefit from Medicaid expansion can’t afford to buy insurance, which is the whole point. Unless you’re a Tea Party Republican, in which case the whole point is to defeat Medicaid expansion and, in their eyes, Obamacare.

And that, of course, is what supporters of Medicaid expansion fear: That all of these substitute bills and delays are nothing but a dog-and-pony show that will ultimately result in the failure of Michigan Medicaid expansion.

If Medicaid expansion doesn’t pass, the only failure will be the inability of Senate Republicans to do the job they are sworn to do: looking out for the best interests of Michigan and its residents.

[Image courtesy of the Michigan Nurses Association.]