Michigan Gov. Rick Snyder addresses a gathering of local officials and business people at Crystal Gardens Banquet Center Thursday afternoon Jan. 17, 2013 in Genoa Township, Mich. / Alan Ward, AP
LANSING, Mich. - A day before he delivers his budget message to the state Legislature, Gov. Rick Snyder said Wednesday he will support an expansion of Medicaid in Michigan.
The expansion would allow Medicaid to cover about 470,000 more uninsured low-income residents in the state of almost 10 million people. Now 1.9 million people receive Medicaid benefits.
"It's a win for all," he said at a hospital news conference here while flanked by doctors, nurses and health officials.
But under the federal Affordable Care Act, which detractors often refer to as Obamacare, nearly half a million more people would become eligible for assistance. That's because the law would expand coverage to people within 133% of the federal poverty level - $11,702 for a single person with no children and $23,021 for a family of four in Michigan.
However, states have an option to accept or reject the expansion.
So while Snyder, a Republican, is signaling his support, approval for the expansion still has to go through the state Legislature where it will face many skeptics who don't believe in supporting any aspect of Obamacare.
The move comes two days after GOP Gov. John Kasich in neighboring Ohio also decided to seek expansion of his state's Medicaid program, one of several governors in Republican-led states including Arizona, Nevada, New Mexico and North Dakota that are leaning toward extending coverage.
This is the second time in less than 18 months that Snyder has bucked 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 the federal government will control.
The federal government has promised to finance the Medicaid expansion totally for three years. But federal support will decline to 90% by 2020.
Michigan taxpayers will have to pick up the remaining 10%, which could run $150 million to $200 million a year, said state Sen. Roger Kahn, chairman of the Senate Appropriations Committee and a Republican from Saginaw Township, Mich.
Snyder's support for Medicaid expansion "really is a big deal," said Director Marianne Udow-Phillips of the Ann Arbor, Mich.-based Center for Healthcare Research & Transformation, which provided research to the governor's office.
The center concluded that Michigan would save more than $1 billion in the next 10 years as the federal government picks up the cost of health care for those who now don't have insurance. Moreover, most primary care doctors reported to the center that they are able to accept new patients who would have insurance, she said.
"What's really powerful about this is that the governor did come at this from a very objective, analytical approach," she said. "He looked at the facts. He pulled research from our center and ... lots of people," Udow-Phillips said. "I don't want to say we're surprised, but we're very pleased that the facts did speak for themselves."
Twenty states and the District of Columbia have said they will participate in Medicaid expansion, according to consulting firm The Advisory Board Co. Five other states are leaning toward participating while 16 states now have either decided against the expansion or are leaning that way. The remainder have not committed.
Dr. Richard Armstrong of Newberry, Mich., called the Michigan governor's decision "a colossal mistake."
A general surgeon in the state's Upper Peninsula, Armstrong is chief operating officer of the national organization Docs4PatientCare, which opposes the federal health-care reform law. Expanding Medicaid simply grows a broken system full of waste and fraud, he said.
"I have no problem with taxpayers paying money for people who are truly disabled and truly poor," Armstrong said. "I have no problem with that, none."
Docs4PatientCare supports an overhaul that would boost private competition in the insurance market, reform medical liability and limit Medicaid. Armstrong said people don't understand the economics of Obamacare and the provision for Medicaid expansion: Taxpayers bear the cost.
"I've gotten so blunt about it sometimes I've taken my wallet out and said, 'It comes from here,' " he said.
The primary way Michigan will save up to $1 billion in the next decade is through reducing the number of expensive emergency room visits, the Center for Healthcare Research & Transformation said. As more people get insurance coverage, they'll make more economical doctors' appointments and get treatment before a health concern becomes an emergency.
Of 10,000 patients served at Covenant Community Care's five locations in Detroit and Royal Oak, Mich., about 6,000 lack insurance, said Paul Propson, Covenant's executive director. The state now picks up most of their care.
Expanding Medicaid not only will shift costs to the federal budget, Propson said it will improve care for patients who think they can seek treatment only in crises.
"We just will be able to provide better care and get access to specialty care and more rapid treatment. And they can afford their medicines without worrying that they might lose their home," he said. "To think that the poor (would) be the ones that will be left out of the national program to provide for the needs of Americans - it would be shameful."
Contributing: The Associated Press
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