With Michigan Vote Tuesday, Half of States Set to Expand Medicaid

After months of debate over the question of Medicaid expansion under the Affordable Care Act, the Michigan Senate Tuesday approved a plan to expand coverage to an estimated 470,000 low-income persons.

With Michigan joining the expansion column, half of all states have taken the option provided by the Affordable Care Act. Five states continue to debate the issue and 21 have decided not to go forward with expansion on January 1, 2014.

The first time a vote was taken it fell one shy of the 20 affirmative votes required. After quickly voting to allow a reconsideration of the vote, members met behind closed doors.  According to the Detroit Free Press coverage, “Several hours later, an amendment was offered and Sen. Tom Casperson, R-Escanaba, switched his no vote to a yes, giving it a winning 20-18 margin. The amendment basically says that hospitals can’t charge Medicaid patients more than 115% of what they charge Medicare patients.” Besides Casperson, seven other Republicans joined with all 12 Democrats to support the expansion.

“The Healthy Michigan plan emphasizes personal responsibility,” Gov. Rick Snyder said in a press release after the vote. “Those covered by the plan will be required to share in the costs through premiums. There also will be incentives for them to take responsibility for their lifestyle choices and to maintain or improve their health.

“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.”

The Michigan Senate failed to get the two-thirds vote necessary for the bill to be effective immediately, so it will not become law until April 1, 2014, three months after the Affordable Care Act allows for 100 percent federal payment of Medicaid expansion costs. Health officials say the Senate may reconsider the vote again to give the bill immediate effect.