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Michigan Senate OK's Medicaid Expansion

By Julie Edgar
WebMD Health News

Reviewed by Lisa Zamosky

Aug. 29, 2013 -- Michigan took a significant step this week toward becoming the 25th state to approve the expansion of Medicaid, a key part of the Affordable Care Act.

The Republican-controlled Senate approved the bill by a vote of 20-18. Because lawmakers couldn't win a two-thirds majority in support of the law -- or at least 26 votes -- it won't go into effect until April 1, 2014.

"I'm glad we were able to move forward on this bill for the hundreds of thousands of people across Michigan who will now have access to health care along with the significant burden this will lift off our state's budget," said Senate Minority Leader Gretchen Whitmer (D-East Lansing). "But it's disappointing that the Senate Republicans continue to hold this important legislation up, withholding health care for Michigan's citizens while costing the state millions of dollars."

The Senate could return after the Labor Day holiday next Tuesday and reconsider an "immediate effect" vote, which would expand Medicaid as of Jan. 1, 2014. After that, the bill would go to the House, which had passed a similar bill, for final approval, and then to Gov. Rick Snyder, who has lobbied hard for the passage of Medicaid expansion.

The bill would cover 323,000 uninsured residents in 2014 and 470,000 by 2021. Medicaid now covers 1.9 million Michigan residents.

As of Aug. 28, 21 states have voted against Medicaid expansion, and five (Indiana, New Hampshire, Ohio, Pennsylvania, and Tennessee) are still debating it. It's intended to expand health coverage to lower-income people: those with incomes at or below 138% of the federal poverty level, or $15,856 for an individual. Expansion is also intended to lessen the financial burden on hospitals caring for the uninsured. The federal government will cover the cost of expansion through 2017. By 2020, its contribution will drop to 90%.

The 21 states that are not moving forward will forgo billions in federal dollars. The Kaiser Family Foundation puts the number at $35 billion in 2016 and $345 billion from 2013 to 2022.

SOURCES: Kaiser Family Foundation: "Status of State Action on the Medicaid Expansion Decision, as of August 28, 2013." Kaiser Family Foundation: "Analyzing the Impact of State Medicaid Expansion Decisions." Michigan's Journal of the Senate, Aug. 27, 2013. Press release, Sen. Gretchen Whitmer. Robert McCann, communications director, Michigan Senate Democratic Caucus.

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