Gov. Rick Snyder's proposal to expand Medicaid to nearly 500,000 Michigan residents, is not getting a warm reception in the state House of Representatives.
The Appropriations subcommittee handling the Department of Community Health budget passed the funding document without the Medicaid expansion, as well as other Snyder proposals, including: dental services for low-income children, health and wellness initiatives, mental health and substance abuse services for veterans and an infant mortality program.
The federally funded Medicaid expansion would pay 100% of the costs through 2017. The federal support would ratchet down to 90% by 2020. And it is that ratcheting down that Republicans in the House said they feared: that the federal money could not be guaranteed and would leave the state to provide health care for low-income residents.
Snyder's proposed budget included $181.7 million coming from the federal government for the expansion. That revenue stream was removed from the DCH budget with the committee's 6-2 vote to OK the budget.
"This would save the state money, make people healthy and allows us not to make other cuts in the budget," said state Rep. Brandon Dillon, D-Grand Rapids, whose amendment to restore the expansion funding failed on a straight party-line vote.
The vote on the budget, however, doesn't mean the Medicaid expansion is dead, said state Rep. Matt Lori, R-Constantine. The governor still needs to do more education on the benefits of the expansion before Republicans can support it, he said.
Health care proponents were disappointed that the subcommittee omitted the Medicaid expansion.
"The subcommittee members voting in favor of this plan are deliberately turning away money to pay for needed health care and mental health services that will save lives in Michigan," said Gilda Jacobs, president and CEO of the Michigan League for Public Policy.
But Americans for Prosperity of Michigan, a tea party-affiliated group, was thrilled that House Republicans rejected the federal dollars.
"The Medicaid expansion proposed by the Obama administration poses significant risk to the long-term fiscal health of our state," said Scott Hagerstrom, state director of Americans for Prosperity-Michigan. "Gov. Snyder has touted his commitment to making Michigan a state recognized for fiscal responsibility and smart budgeting principles ... yet he supports a Medicaid expansion that will drive our federal government deeper into debt."
Currently, 1.9 million adult Michiganders receive Medicaid benefits, but under the Affordable Care Act nearly 500,000 more residents could be eligible for the assistance. That's because the ACA would expand coverage to people who fall within 133% of the federal poverty level -- $11,702 for a single person with no children and $23,021 for a family of four.
Wednesday's vote was the third time in two days that budget legislation has advanced without provisions for major initiatives called for by Snyder.
On Tuesday, the House Appropriations Subcommittee on Transportation moved the transportation budget without including $1.2 billon in additional road and bridge repair money requested by Snyder.
Also Tuesday, House and Senate appropriations subcommittees on corrections moved prison budgets that did not include about $24 million in savings that the Michigan Department of Corrections would realize under Medicaid expansion, since more prisoner health care would have been billable to the federally funded program.
Lawmakers stress the budget is at an early stage in the legislative process and changes are still likely to be made.
Snyder acknowledged that it's a challenge to get everything you want in the budgeting process, but said he hopes the Legislature will take another look at some of his proposals, including the Medicaid expansion.
"It's best for Michigan's citizens. It's about helping people in need and it saves us money," he said.
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