Affordable Care Act, Obamacare — December 31, 2013 at 10:16 am

Michigan Medicaid expansion takes a giant step forward with HHS approval


Federal sign-off on the “Healthy Michigan” plan puts start date on target for April 1, 2014.

It should have been sooner. It should have been easier. But Medicaid expansion is coming to Michigan.

On Monday, the U.S. Department of Health and Human Services (HHS) approved Michigan’s waiver request to expand Medicaid to individuals at 133 percent of the federal poverty line. This means roughly 450,000 low-income Michiganders will gain health insurance and access to preventive and routine care — many for the first time.

These aren’t the “takers” the GOP keeps railing on about. These Michiganders are largely the working poor, seniors, veterans and children. The federal government pays 100 percent of the cost to start, decreasing incrementally to 90 percent by 2020.

As we reported here at Eclectablog throughout 2013, expanding Medicaid in Michigan was no easy feat. There were times it seemed unlikely to pass the Legislature, even with Governor Rick Snyder’s support.

But thanks to the tireless efforts of supporters, including many grassroots activists, pass it did. However, it included some fairly significant deviations from the provisions originally intended under the Affordable Care Act. (Don’t call it Obamacare. That’s why Michigan Republicans opposed expansion in the first place.)’s Jonathan Oosting explained Michigan’s Medicaid expansion plan this way:

The ‘Healthy Michigan’ plan, as championed by the Republican governor and approved by the Legislature, will allow the state to expand Medicaid eligibility to up to 133 percent of the federal poverty level, which is roughly $15,000 for an individual and $34,000 for a family of four.

Michigan’s expansion plan required approval of a federal waiver because of unique reforms, including required co-pays and income-based premiums that recipients can reduce by making healthy lifestyle choices in consultation with a physician.

Michigan Medicaid expansion could have kicked in on January 1, 2014, but the Republican-led Legislature did not vote to give the law immediate effect. Unlike a majority of laws they passed in 2013.

That’s a move that will cost the state an estimated $600 million, and keep the uninsured without coverage that much longer.

According to Oosting’s report, Michigan must apply for a second federal waiver to implement a soft cap on coverage. After 48 months on Medicaid, new recipients will have the choice to pay higher premiums or seek private insurance at This measure was written into the law to appease Republicans in the Michigan Legislature.

Still, the expansion of Medicaid with some special provisions is better than no Medicaid expansion. People will no longer have to rely on the emergency room for care they can’t pay for, which will translate into lower costs for those who buy insurance and improved health for the people of Michigan. People will no longer have to go without care, improving life expectancy and quality of life.

The Detroit Free Press quoted Director of the Michigan Department of Community Health Jim Haveman on the announcement of the HHS approval.

‘We’re glad it happened. It was a lot of work. The legislature should be happy. This is what they worked for.’

Michiganders should be able to start applying in about a month, he said.

‘We’ve been taking this in stages, now we can move to the next sequential stage,’ he said.

As always, we’ll continue sharing updates and the information Michiganders need to know about applying for Medicaid when the time comes.