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State Senate may vote on Medicaid expansion in late August

State Capitol 2

From Gongwer News report

Senate Majority Leader Randy Richardville on Wednesday said he believes it is probable that the Senate Medicaid workgroup will have a proposal ready by mid-week next week, and the full chamber would vote on the proposal in late August.

 “My guess is that if things come out of committee, and it’s possible that they will on (July) 31 st, that that would give the entire Senate a couple of weeks to look at things, study it over, talk to people, and be ready for a vote,” Mr. Richardville (R-Monroe) told reporters after a brief Senate Government Operations Committee meeting. “So my tentative plan would be to put something up on the 27 th and the 28 th (of August).”

AARP Michigan strongly supports Medicaid expansion. There are 75,000 state residents between ages 50 and 64 who do not have health insurance and would be covered under the plan.

 The committee met on Wednesday to discuss the progress of Mr. Richardville’s Senate Medicaid workgroup, but Mr. Richardville said the workgroup was not ready to put forth a proposal for public testimony. Instead, he said, public testimony could be expected at the committee’s next meeting on July 31.

 “I asked (the group) to give me a progress report and if we were ready, then we would take a vote and have discussion. But they weren’t quite there yet,” Mr. Richardville said. “(Sen. Roger Kahn) thinks they’re between a half and two-thirds complete with something, so I didn’t think it made a whole lot of sense to talk about something that wasn’t ready for a full discussion.”

 Mr. Kahn (R-Saginaw Township) has not divulged many details about the group’s work except that it is discussing HB 4714, as passed by the House before the Legislature went on summer break in June, as well as other alternatives. His update to the committee, read for those in attendance, said the workgroup had identified several reforms that could be implemented without federal waiver approval while improving the program’s delivery statewide.

 And Mr. Richardville remained similarly coy on greater details of any proposal after the meeting.

 “I don’t want to get into too much detail because they’re not quite done but I think it’s going to be things that would appeal more to a conservative group than anything else,” Mr. Richardville said. “We want to make sure that if the waivers are not approved that the taxpayers of Michigan aren’t held responsible (and) there’s some kind of individual responsibility with people that are going to be getting different kinds of health care.”

 The House-passed plan, which Governor Rick Snyder supports, relies heavily on the federal government providing waivers to the state.

 Mr. Kahn’s letter also stated that he was personally committed to reforming Medicaid to ensure there is personal responsibility and independence by the enrollee, as well as provider responsibility; reducing uncompensated care; mitigating the federal Patient Protection and Affordable Care Act’s costs on the state; limiting the state’s donor tax status to the federal government; producing state savings; creating more jobs; and improving the health of state residents.

 Though not much has been said about the timing involved with presenting a changed or completely new proposal first to the committee and then to the Senate, Senate Minority Leader Gretchen Whitmer (D-East Lansing) said after the Government Operations meeting that the administration has maintained that “time is of the essence,” especially if federal waivers are involved.

 “If we’re going to open up enrollment on October 1, and we need to seek all these waivers, that is a very time-consuming process and this is really at the end of the day about covering the poorest, most vulnerable people in our state,” Ms. Whitmer said.

 She reiterated that Senate Democrats were prepared to cast their votes in support of HB 4714 as it came over from the House before the Legislature essentially adjourned until the fall, and has continued to express concern to Mr. Richardville about the lack of public input in the workgroup process. Of the reforms, she said she has talked to her members and is aware that Sen. Bruce Caswell (R-Hillsdale) has put something on the table that “turns our back on all this potential federal aid coming into Michigan and would cost half a billion dollars of General Fund money.”

 Indeed, Mr. Caswell has long supported expanding access to care for low-income individuals, but without the expansion of Medicaid by a federal mandate. He has so far introduced SB 422, but the legislation is undoubtedly a bare-bones version of what it could become if the workgroup decides the route that legislation lays out is preferred.

 Late Wednesday afternoon, Sen. Patrick Colbeck (R-Canton Township) also released a statement about a pair of bills that he plans to introduce regarding the Medicaid issue that “provide a free market alternative that expands access to quality care without expanding government.”

The first bill, slated to be SB 459, would provide the regulatory infrastructure for the solution within the confines of the ACA, he said. The second bill would convert Medicaid enrollees to qualified health plans featuring direct primary care services and high deductible health plans all within a health savings account. He said he will discuss the legislation with the workgroup on Thursday.

 “We can use this as an opportunity to put in place a free market based system that will not only accomplish the stated objectives of Obamacare but will also establish Michigan as a destination state for employers seeking quality, affordable healthcare for their employees,” he said. “If we can provide quality services at a greatly reduced cost, we can draw patients from other states and countries that are looking for better access to quality care while creating new healthcare jobs in Michigan.”

 At stake is not only keeping House support for the Senate proposal but also keeping Democratic support in the Senate. With a number of Senate Republicans in opposition to what they view as an expansion of government, garnering Democratic support is still considered a factor of any successful plan.

 Of keeping Democratic votes, Mr. Richardville said, “What we’re trying to do is see what can be most palatable to the biggest number of senators.”

 Ms. Whitmer, however, kept stern her caucus’ level of support.

 “I just hope that they do it right and they do it well enough that it garners bipartisan support,” she said. “They kowtow to the tea party, that’s going to put Democratic support in jeopardy.”

 Arch-conservative group Americans for Prosperity Michigan released a statement on Wednesday applauding the senators for taking their time on the issue and having a “critical eye.”

 “Our state Senate ought to take all the time they need to study this issue in-depth,” said Scott Hagerstrom, state director of the group. “Proponents argue that government has to spend more of our money to save money. That argument doesn’t even pass the smell test. We certainly hope our Senators see through the rhetoric, stand on principle, and reject Washington’s Medicaid expansion.”

 The Michigan Association of Counties issued a statement supporting the passage of HB 4714, touting its benefits of saving about $200 million a year in health care spending from Michigan taxpayers. The legislation would also provide funding that would support preventative health care and mental health treatment, it said.

 “This plan wouldn’t just provide health insurance to low-income workers who are uninsured today,” said Thomas Bardwell, president of the MAC Board of Directors. “But it also would require some responsibility from the participant in the form of co-pays, along with incentivizing participants to practice a healthy lifestyle.”

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