Affordable Care Act, Michigan Republicans, Obamacare, Rick Snyder — November 8, 2014 at 11:15 am

An open letter to Gov. Rick Snyder: Give Michigan a state-based insurance marketplace


Prove to your constituents that you care about everyone in the state — not just big-money special interests.

Dear Governor Snyder:

I didn’t vote for you in either election, but you are Michigan’s governor. I haven’t agreed with you on much, but you did support Medicaid expansion in Michigan, although you could have done a lot more to urge the Legislature to act decisively. You also said you supported Michigan creating a state-based insurance marketplace under the Affordable Care Act (ACA, aka Obamacare), although you put up even less of a fight on that one.

Now, with your re-election behind you and the health insurance of nearly 240,000 Michiganders at risk, it’s time to lead.

The U.S. Supreme Court has agreed to hear arguments in King v. Burwell, which could effectively destroy Obamacare by eliminating tax subsidies for consumers in states that chose to use the federal insurance marketplace instead of creating a state-based one. The case is based on a technicality and it’s absurd. (If you don’t know what the case is all about, this is a great explainer.)

Here’s why it’s absurd. Michigan and the other states chose to use the federal marketplace instead of creating state-based exchanges. That means the federal marketplace IS the state marketplace established by those states. So the answer to the question of whether the ACA intended to provide tax subsidies to all Americans, or only those in states that chose to create state-based marketplaces, seems obvious to me. The law is a federal one, with its requirements and benefits extended to every state. However, there’s no telling how the Supreme Court will rule.

You could protect Michiganders from a ruling against the ACA with one simple step: Create a state-based marketplace. It’s in keeping with your stated commitment to fostering a healthier Michigan. It would allow Michigan residents to continue receiving the tax subsidies that make health insurance affordable to them — insurance many of them will not be able to afford without assistance, given that more work needs to be done to reduce the exorbitant prices set by insurance companies.

Yes, I know Attorney General Bill Schuette is part of a similar lawsuit against the ACA, Halbig v. Burwell. He and Michigan’s Republican-led Legislature are on a crusade — like so many other Republicans nationwide — to destroy Obamacare.

But you’ve taken a more reasonable approach to the ACA. You adapted Medicaid expansion in a way that helped Michigan’s poor and working-poor gain coverage despite the ideology and rhetoric of your party. In fact, your customization of Medicaid expansion is being heralded as an example for other “red” states.

Now is the time to convince people that you can lead and govern as the moderate you say you are. Creating a state-based insurance marketplace should not be a hard sell, even to this Legislature. You don’t want to see Michiganders left without health insurance, which drives up the cost of insurance for everyone else and puts the health of the uninsured at risk. You don’t want to increase the burden on hospitals who pay when patients are forced to use the emergency room because they don’t have insurance coverage — a burden that is already being lifted by Obamacare. You don’t want to see Michigan’s residents do without the routine care that can prevent illness and diagnose problems when they can be treated more effectively and less expensively. Right?

Prove you care about all Michiganders, Governor Snyder, and do the right thing. Stand up to the extremists in your party and get the ball rolling on creating a state exchange. There’s plenty of time to get one set up for 2016. You could even create jobs by hiring one of Michigan’s many tech firms to do the work. And, as you did by customizing Medicaid expansion to cut through political red tape, you could position yourself as a leader among Republicans — the party that claims after the midterm elections that they are going to work to get things done that benefit Americans.

Lead the way for other Republican governors and prove to Michiganders that your stance as a moderate is more than just campaign rhetoric, Governor Snyder. I dare you.

[Caricature by DonkeyHotey from photos by Anne C. Savage for Eclectablog]