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Michigan agrees to expansion of Medicaid under Obamacare

The state of Michigan in a 20 to 18 vote has become the twenty-fifth state to approve the expansion of Medicaid as part of the Affordable Care Act. The expansion for other states is still under debate with five states currently debating the issue. Another twenty-one states have decided not to approve the expansion.

How close was the Michigan vote?

The vote was close, and it took an estimated eight hours, with a lot of “closed-door politicking and vote wrangling,” for Michigan lawmakers to get the votes they needed. According to a CNN report, “The plan almost fell apart when Republican Sen. Patrick Colbeck decided not to vote the first time the bill came up, leaving it with a 19-18 tally, one vote shy of passage.”

Democrats were always supportive of the expansion, although with the approved amendment some of the costs have been shifted to the recipients of the coverage. Under the passed amendment hospitals can't charge Medicaid patients more than 115% of what they charge Medicare patients.

According to Democratic Sen. Gretchen Whitmer, the state should see a significant drop in uninsured Michigan residents. She claims that the expansion would help approximately 320,000 the first year and an estimated 470,000 people by 2020.

What may have been surprising to some is that eight Republican senators joined with all 12 Democrats to support the expansion. Some Republicans agreed to support the bill because the Michigan plan emphasized personal responsibility.

According to Gov. Rick Snyder, "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."

Other Republicans who supported the bill only did so because they believe Obamacare is here to stay. For instance, Republican Sen. Howard Walker called the Affordable Care Act one of the worst pieces of legislation passed by Congress. He noted, however, that once the Supreme Court validated the bill he had no choice but to vote yes to expand Medicaid.

Other Republicans argued that expanding federal government entitlement spending at a time when our nation faces crushing federal debt is incredibly irresponsible.

Who will the Michigan expansion affect?

Medicaid will be offered to individuals who fall within 133% of the federal poverty level. The federal government pays for some of the expansion until 2017 but limits their contributions by 2020. This reduction in federal contributions is what has many governors and state legislators very concerned about the cost for some states who are already very cash strapped.

Right now most states provide Medicaid to those who are disabled, who are very poor and to children. This move to expand Medicaid coverage will affect the “working poor” who have jobs but who are not provided health insurance under their employer’s plan. Expanding Medicaid in Michigan will likely impact 470,000 low-income residents.
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