21 June 2013

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Story Originally Appeared in Detroit News

Snyder blasts Senate for shelving Medicaid bill
'Take a vote, not a vacation,' governor tells fellow party members

Lansing — Republican senators dealt Gov. Rick Snyder’s agenda a major setback Thursday when the Senate declined to vote on a massive expansion of the Medicaid health insurance program for the poor in the face of conservative opposition.

With a narrow timetable for Michigan to decide whether it will add more than 400,000 low-income residents to its Medicaid rolls, Snyder offered an unusual criticism of fellow Republicans on Thursday for adjourning for a two-month summer recess.

“Take a vote, not a vacation,” Snyder said about Senate Republicans. “I call on Michiganders to stand with me, (and) I ask you to sustain that effort until we get that ‘yes’ vote.”

The Senate’s GOP caucus met twice Thursday but lacked the support of half of its 26 senators to bring up the bill for a floor vote. The bill would have expanded the income eligibility cap for Medicaid coverage to all childless adults earning about $15,000 annually. Most of the 1.9 million Michiganians currently on the Medicaid rolls are children, seniors and disabled adults.

Several Republican senators said they need more time to digest the impact of adopting the federally funded Medicaid expansion and cost controls attached by the GOP-controlled House.

“They’ve dumped a truck full of horse manure on our driveway, and we have to figure out what to do with it,” said state Sen. Mark Jansen, R-Grand Rapids.

In recent weeks, tea party activists have threatened to field primary challengers against Republican senators who vote to expand Medicaid — a key component to lowering the number of uninsured Americans under President Barack Obama’s Affordable Care Act.

“I think that the tea party today effectively killed our ability to cover half a million people in the state of Michigan,” said Senate Minority Leader Gretchen Whitmer, D-East Lansing.

Americans for Prosperity, a conservative group planning to target House Republicans who voted for the Medicaid bill last week, hailed the Senate’s inaction Thursday.

“This is a win for Michigan taxpayers,” said Scott Hagerstrom, state director of AFP Michigan. “My hat’s off to Senate Republicans for standing up to the governor of their party.”

The federal government’s offer to cover all expansion costs through 2016 and gradually fall to 90 percent by 2020 would save the state more than $200 million a year. Snyder proposed putting half of the savings in a trust fund to cover the state’s added costs in later years.

Senate Majority Leader Randy Richardville, R-Monroe, acknowledged the bill likely had the minimum 20 votes to pass — 12 Democrats and eight Republicans — but said he was reluctant to hold a vote without the support of half or 13 of the chamber’s 26 Republicans.

“I want to make sure this is truly bipartisan,” said Richardville, who added the bill isn’t dead and would be reviewed by a summer work group.

Whitmer noted the Senate passed legislation creating a regional transit authority in Metro Detroit and a Detroit lighting authority last year with more Democratic votes than GOP votes.

“It‘s baloney,” Whitmer said of the GOP’s 13-vote threshold. “It’s an excuse not to do something that they, for whatever reason, didn’t want to get done.”

Richardville said he needed more Republican votes because this is a statewide issue. The development was a setback for Snyder, who cut short a trade mission in Israel, flew back to Michigan overnight Wednesday and spent Thursday lobbying reluctant Republican senators to support the bill.

The Snyder administration has said passage of the legislation Thursday was vital to get federal approval of proposed changes to the state Medicaid program before a nationwide expansion begins this fall.

At a Capitol press conference Thursday, Snyder was flanked by leaders of state medical and business associations that support the expansion.

“Real people with real needs will die as a consequence of the failure to provide access to care,” said Dr. Fred Van Alstine, president of the Michigan Academy of Family Physicians.

Snyder said he didn’t even change his clothes after arriving back in Michigan, just putting in his contacts and shaving before returning to the Capitol to lobby Republican senators. He often was emphatic in his support of Medicaid expansion during the press conference, thanking the GOP-controlled House for approving it.

While Snyder urged Michiganians to be positive about their lobbying, Richardville said Snyder’s remarks about the Legislature’s scheduled summer break ran counter to the governor’s mantra of “relentless positive action.”

“I’m just not really sure how that’s relentlessly positive,” Richardville told reporters after the session.

About 26 states so far are planning to expand Medicaid. Most have Democratic governors. While most Republican governors oppose Medicaid expansion, Snyder is among more than a half-dozen GOP governors who back expansion.

Like Snyder, Govs. Jan Brewer of Arizona and John Kasich of Ohio have fiercely battled GOP-controlled Legislatures to adopt the expansion.

Brewer, a tea party favorite who refused to sign unrelated bills until her party complied on Medicaid, signed Arizona’s expansion into law Monday. Prospects of Kasich winning Medicaid expansion before the Ohio Legislature’s summer break appeared dim this week.

State Sen. Patrick Colbeck, R-Canton, who opposed the Medicaid expansion, said the Michigan Legislature should “push back” against the Affordable Care Act mandates and direct individuals to private insurers through the health insurance exchanges that will be set up under the federal law.

“Because ours is going to be free-market-based, our costs would be lower,” Colbeck said.

Even if the Medicaid legislation is approved in the fall, it would face another hurdle. The federal government would have to agree to Michigan’s proposed requirement that able-bodied adults with incomes between 100 percent and 133 percent of the poverty level contribute up to 5 percent of their income toward their medical care. Another federal waiver would be needed to require the contribution be raised up to 7 percent after four years in the program.

The Senate is scheduled to meet again on Aug. 27. But state Sen. Roger Kahn, R-Saginaw, a physician who has championed the expansion, said Richardville could call back senators earlier.

This prospect is complicated by the scheduled installation of new carpeting in the Senate chamber during the summer. But Kahn said the Senate could meet elsewhere, such as Michigan State University’s Kellogg Center.

“It’s my belief that the politics trumped the policy in this case,” Kahn said. “But if there’s one thing I’ve learned about politics, it’s when they tell you it’s over, it’s not over.”

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