Medicaid expansion passes, but law may be delayed

Although the Michigan State Senate passed House Bill 4714, expanding Medicaid to hundreds of thousands of low-income adults, it might not be put into law until well after the January 1st deadline for federal funding.

The Affordable Care Act measure initially failed with a 19-18 vote, with one State Senator opting to abstain. State Senators then approved a motion to reconsider, and voted again two hours later to pass the bill with a 20-18 tally. State Senator Tom Casperson changed his vote to ‘yes’ after his amendment was approved.  The added wrinkle ensures that residents without healthcare coverage will not be charged an exorbitantly higher rate than their card–carrying counterparts at hospitals.

“I voted ‘no’, and ultimately sat down with the director and others and shared my concerns,” Casperson said.  “My concern is Northern Michigan–not just the U.P.–but Northern Michigan, the rural areas.  We’re struggling up there, and that’s been shared with me by my people overwhelmingly. So, that’s a conversation the director and I had. I wanted to see more done on their behalf if I’m going to take his vote. They need help.”

After the bill was formally passed, Casperson and twenty-three State Senators from both sides of the aisle voted to give the law immediate effect just as their colleagues in the house had done back in May, which would allow the state to meet the January 1st federal funding deadline.

But, in order for an immediate effect to pass, it needs a two-thirds majority vote.

“For a bill to have immediate effect means that as soon as the bill is signed into the law that law goes into effect,” Communications Director for the Senate Democratic Caucus Robert McCann said.  “If it doesn’t get the votes for immediate effect, it can’t go into law until 90 days after the start of the next year. By not giving this Medicaid expansion program immediate effect, we are left with a program that’s simply stalled until next April.  As the Department of Community Health has told us, for each day after January 1st next year that this program isn’t running, Michigan loses out on $7 million.  If we’re looking at 90 days after the start of the year, that’s $630 million Michigan could lose out on unless Republicans do the right thing and come back and give this immediate effect.”

Because the Republicans currently hold the majority in the Senate, they are the only ones who can motion to reconsider the immediate effect vote.

The window to do so is closing, as the Senate will reconvene next Tuesday, September 3rd at which time they can send the bill “as is’ back to the house so they can affirm the new amendment. If the house approves the Healthy Michigan Plan “as is,” without immediate effect, and Governor Snyder signs it, Michigan and the 320,000 people affected by the measure will miss out on three months of federal funding.