Michigan is the 24th state to approve the Medicaid expansion. What’s taking the other 26 so long?
It was a tough battle, all the way to the end, but on Tuesday night, the Republican-dominated Michigan Senate approved the Medicaid expansion offered through the Affordable Care Act. The state House of Representatives already passed the bill in June, by a lopsided vote of 76-31, in spite of the fact that the majority is held by the Republican Party. Governor Rick Snyder announced his support for the legislation last spring.
Observers in the gallery on Tuesday, frustrated that the Senate took two and a half months to take up the bill, periodically chanted “time to vote”. But vote they did — twice.
The result was expected to break down as 19 for and 19 against, giving Lt. Gov. Brian Calley the opportunity to break the tie by voting ‘yes’. However, at the last minute, one of the ‘no’ voters abstained instead, leaving the vote at 19-18 against. The Senate immediately decided to reconsider the vote and went into recess. What followed was an eight-hour session of behind-closed-doors arm wrestling.?By finally offering an amendment that prevents hospitals from charging Medicaid patients more than 115% of what Medicare patients have to pay, supporters of the bill obtained another ‘yes’ vote. The final outcome was 20-18 in favor. The amended bill now goes back to the House for final approval, and then on to Gov. Snyder for his signature.
Sen. Gretchen Whitmer, D-East Lansing, said:
We know we all pay for uncompensated care in this state. But with this expansion, 320,000 people will be covered in the first year; 470,000 by 2020. Our uninsured population will drop by 46 percent.
That’s a pretty hefty drop, and one that Republican governors around the country are weighing. Snyder joins Arizona’s Gov. Jan Brewer in successfully pushing the program through in spite of significant opposition from their party, while Rick Scott of Florida and John Kasich of Ohio continue to struggle with recalcitrant legislatures in an effort to get the expansion passed. As Snyder put it, after the vote:
Healthy Michigan will make our state healthier and stronger. It also will save money for the state’s taxpayers and job providers, help control medical costs, improve the state’s business climate, and boost our economy. All of these are crucial to continue Michigan’s comeback.
This would seem to be a no-brainer for states, who for the most part are struggling financially, but not even half of them have embraced the expansion. While it is being widely reported that Michigan is the 25th state to approve the Medicaid expansion, that figure actually includes 24 states plus the District of Columbia. Twenty-one states have voted against it and five are still debating the issue.
The opposition is full of ignorant statements about reality, such as that of Sen. Patrick Colbeck, R-Canton, the man who initially abstained in the voting:
Hitching our wagon to this Obamacare train is a high-risk venture. If this goes into effect, 30 percent of our population is going to be on Medicaid, and then 70 percent is going to be paying for 30 percent.
The 70 percent is already paying for the 30 percent. They just currently do it through the hidden method of increased medical costs as emergency rooms pick up the burden, to say nothing of other hidden costs, like the loss of work due to illness. And in case Colbeck hasn’t noticed, unemployment is an enormous problem in Michigan–especially in its biggest city, Detroit, whose own financial difficulties have become legend.
However, the outcome in Michigan is encouraging in terms of some conservatives becoming more adaptive to the reality in their states and in the nation. In June,?Rep. Mike Shirkey, R-Clarklake, said:
?… the opportunities for us to seize control of how Michigan defines our Medicaid system significantly outweigh the philosophical opposition. I believe it’s time for us to stop playing defense with something that is the law of the land, and begin to play offense.
A Republican who thinks the opportunity to do good outweighs philosophical opposition? That ought to cause a few people to pick their jaws up off the floor — on both sides of the aisle.
Featured image from eclectablog.com.
edited by eap
