After an initial failed vote and hours of dramatic, last-minute legislative scurrying, the Michigan state Senate finally gave approval to Obamacare’s optional Medicaid expansion, extending health insurance to over 400,000 poor Michigan residents and cutting the state’s uninsurance rate by more than 46 percent. Gov. Rick Snyder (R) is expected to sign the bill as soon the Michigan state House, which has previously approved the expansion, takes a concurrent cote to affirm the Senate’s version of the legislation.
Victory was far from assured. Despite months of intensive lobbying for the expansion by the state’s hospitals and its GOP governor, the Republican-controlled Michigan Senate failed to pass the Medicaid bill on its first try. The chamber currently consists of 26 Republicans and 12 Democrats, meaning that at least eight Republican senators needed join with the Democratic caucus to pass the bill.
It looked like the chamber had the necessary votes at first. But Sen. Tom Casperson (R) — one of the GOP senators who was expected to vote for the expansion — abruptly decided not to, according to Talking Points Memo. The bill still could have passed at that point, since a 19-19 tally would have given the tie-breaking vote to Lt. Gov. Brian Calley (R), who had promised to stand by Snyder and vote in favor of the expansion. But ardent expansion opponent Sen. Patrick Colbeck (R) denied that outcome by abstaining from the vote. Even though Colbeck’s abstention made the final tally 19-18 in favor of Medicaid expansion, Michigan Senate rules require at least 20 “yea” votes for a bill to pass.
But after some intensive behind-the-scenes lobbying and meetings between the two parties, pro-expansion senators were able to get Casperson back into the fold in exchange for passing an amendment that changes the way hospitals get reimbursed for uncompensated care. The final expansion bill passed at around 8 p.m. on Tuesday.
That should come as a huge relief to low-income Michigan residents who will now have access to basic health insurance benefits for things like hospital visits, prescription drugs, and mental health services. Nearly 40 percent of Michiganders with incomes below 139 percent of the Federal Poverty Level are uninsured. Obamacare’s Medicaid expansion expands eligibility for the program to people making up to 138 percent FPL.
Several prominent GOP-led states — including Arizona, New Mexico, and Nevada — have embraced the Medicaid expansion. The Republican governors in those states have cited a combination of robust federal funding, hospitals’ enthusiasm for the Obamacare provision, and the inhumane status quo of millions of poor people without health insurance as reasons to expand Medicaid.
Some states with Republican governors, like Virginia and Ohio, still have Medicaid expansion bills working their way through the legislative process, but they’re facing significant opposition from Republican lawmakers. Gov. John Kasich (R-OH) has urged Republicans to expand the program, asking, “What would Ronald Reagan do?” But governors’ support for the initiative doesn’t always ensure successful passage. Florida Republicans refused to pass Medicaid expansion and extend coverage to more than a million low-income residents, despite Gov. Rick Scott’s (R) surprising endorsement of the policy.