In a surprise move, Gov. Rick Snyder said today he has asked for help from the President Obama administration in convincing state Republicans to accept federal money to expand Medicaid, the Detroit Free Press reported.
It’s surprising because much resistance to Obamacare and the Medicaid expansion seems driven by a ideological loathing of federally run programs and mandates, and hearing from the feds is not likely to win a lot of heart and minds in Lansing.
The fact that Snyder is now reaching out to federal officials likely reflects recognition on his part that his plan to expand Medicaid is in serious trouble – and probably doomed. Both the state House and Senate have refused to include the expansion in a proposed budget that would begin Oct. 1, although one proposed Republican counter-measure would place a four-year limit on benefits.
Almost certainly, the feds would reject this limitation out of hand.
For Democrats – and nearly the entire healthcare industry in Michigan – this Republican opposition has been surprising since the feds fully fund the expansion through 2017 and pay 90 percent of the cost beginning in 2020. About 470,000 more low-income Michigan residents would be added to the program.
Much of the debate over this expansion seems to revolve around the following. Democrats say that hundreds of thousands of low-income people in Michigan simply can’t afford health care, and the state should accept federal funding to keep them healthy. Republicans argue the feds simply can’t be counted on to keep their commitments to fund the expansion (although the government has not reneged on Medicaid funding in nearly a half-century of the program’s existence.)
These arguments so far either ignore, or underplay, two points. If Michigan joins the more than 20 states that are rejecting the expansion, two things will happen:
- Your federal taxes will be used to subsidize health services in other states – states that have adopted the expansion. The idea that you pay federal taxes for services that could benefit yourself or your community goes out the window. This is startling in that perhaps for the first time, Michigan and many other states will have turned away truckloads of federal money – and not channel as many federal bucks as they can back into their own state.
- Your healthcare costs will rise higher than they would be under an expansion. This is simple math. By turning away $2 billion in Medicaid funding annually in Michigan, hundreds of thousands of low-income people will go without preventive health care. Instead, they will wind up in hospital emergency for full-blown life threatening illness – care that is many times more expensive than a doctor’s visit. Soon, hospitals will begin receiving much less funding from the feds under Obamacare (on the premise that emergency room visits will decrease due to the Medicaid expansion.) When those hospital costs in Michigan don’t decrease, guess who will foot that bill. You, John Q. Consumer.
Maybe if supporters, like Snyder, would frame the argument in those terms, there would be more of a groundswell of support in Michigan for an expansion.