Michigan GOP governor proposes Medicaid expansion

By By DAVID EGGERT

LANSING, Mich. (AP) — Gov. Rick Snyder on Wednesday became the sixth Republican governor to back the extension of Medicaid coverage under the Obama administration's health care overhaul, setting the stage for a potential fight with members of his own party who control the Legislature.

"It's a win for all," Snyder said at a Lansing hospital the day before he proposes his next state budget. Snyder was flanked by doctors, nurses and health officials who support the expansion of taxpayer-funded health insurance to about 470,000 Michigan residents.

"This is saving money and improving lives," he said of the expansion when asked about the GOP's opposition to President Barack Obama's signature domestic achievement. "This improves lives at an individual level, where these people can hopefully have a great opportunity to have employment. ... It's a tremendous gain at the individual and family level."

Snyder said the chance to cover nearly half of the state's uninsured is "huge," adding that he is comfortable the health care system can handle the extra caseload.

The federal health care law gives states the option to accept the expansion, refuse it or postpone a decision. But there are benefits for states that choose to expand Medicaid.

The federal government will pick up the entire cost in the first three years and 90 percent over the long haul.

In 30 states led by Republican governors, six governors have now called for enlarging Medicaid. Ohio's John Kasich earlier this week reiterated his opposition to what he called "Obamacare" and the requirement that people have health insurance but said expansion makes sense for Ohio. But Pennsylvania's Tom Corbett said Tuesday he will not pursue an expansion, at least for now, echoing complaints of other Republican governors about the cost, inflexibility and inefficiency of Medicaid.

Snyder is expected to run into resistance from some Republican lawmakers opposed to the health law. Hospitals, doctors and others in favor of Medicaid expansion joined Snyder at his announcement.

He said Medicaid expansion would save the state $200 million a year initially because more people who now receive mental health services and medical care from state-funded programs will instead be covered with federal money. He called for setting aside $100 million a year of those savings so Michigan can kick in for new enrollees down the line. He said the expansion would effectively cost Michigan nothing until 2035.

This is the second time in less than 18 months that Snyder has bucked some in his own party on a major health care question.

His call to implement a state-run online marketplace where the uninsured can get taxpayer-subsidized private coverage died in the GOP-controlled Legislature. Michigan now is on the path toward a partnership exchange controlled primarily by the federal government.

By expanding Medicaid in 2014, Michigan could add about 470,000 people to a program that already serves about one in five state residents.

Three years of full federal funding for newly eligible enrollees are available from 2014 through 2016, gradually phasing down to 90 percent in 2020 and after. The match rate for existing Medicaid participants is 66 percent.

To qualify, household income must be below 138 percent of the federal poverty level, about $15,000 for an individual.

Conservatives are concerned deficit-burdened Washington will renege on the 90-percent deal and also have a philosophical resistance to expanding government programs, particularly one as large as Medicaid.

Rep. Joe Haveman, a Holland Republican who chairs the House Appropriations Committee said Synder's proposal deserves a closer look but Republicans have questions.

"The federal government has a long history of promising support for long-term government programs and then coming up well short when the time comes to honor their commitment," Haveman said in a statement. "We are going to do what's best for the people we serve and do our homework on this proposal before committing one way or the other. Michigan residents deserve that."

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Email David Eggert at deggert(at)ap.org and follow him at http://twitter.com/DavidEggert00

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