When Gov. Rick Snyder decided to ram through freeloading off unions, dishonestly called “right-to-work,” during the Legislature’s recent lame duck session, he knew he was going to take a political hit.
After all, by his own admission, freeloading off unions is a very divisive issue, and Michigan is the most heavily unionized state in which it has been attempted. The margins of victory for Snyder’s election in 2010 and the 2012 defeat of Proposal 2, which would have prevented freeloading off unions, had been provided by moderates and independents who assumed that Snyder wasn’t interested in pursuing this issue.
In an attempt to minimize the political damage, Snyder acted during the lame duck session, furthest away in time from the 2014 election, hoping that it will blow over in time for him to get re-elected. But since he had done something no previous governor did, Snyder is sailing in uncharted waters amidst a poisoned political atmosphere. So far, his political future looks bleak. Snyder’s approval ratings have plummeted, with a recent poll finding that only 36 percent of Michigan voters approve of his performance in office, while 61 percent disapprove. If these numbers are maintained until November 2014, Snyder will be political dead meat.
But the Patient Protection and Affordable Care Act, hated by Republicans such as Snyder, offers an opportunity to show a moderate side while doing a world of good. The Affordable Care Act allows states to expand Medicaid eligibility to people making less than 133 percent of the federal poverty level, including childless adults. The maximum annual income level needed to qualify ranges from $11,490 for a single adult to $23,550 for a family of four. This expansion would add approximately 470,000 people to the 1.9 million Michigan residents already covered by Medicaid.
The Affordable Care Act originally gave teeth to this expansion by allowing the secretary of health and human services to revoke existing Medicaid funding from states that refuse to participate. But Chief Justice John Roberts, in casting the deciding vote to uphold the law in the Supreme Court, ruled that Medicaid expansion can take place but struck down the revocation power.
Seeking support from moderates and independents he has alienated, Snyder, who needs to do damage control, supports Medicaid expansion. It would have a positive effect on people’s lives, improving the health of low income Michigan residents through prevention, early detection and treatment.
Medicaid expansion also makes financial sense. Once implemented in 2014, the federal government will pay the full cost until 2017, after which it is gradually reduced to 90 percent in 2020. By then the state share would amount to $150 to $200 million per year. But under this expansion, the federal government picks up the state’s $280 million a year cost for providing mental health services to 50,000 low income uninsured residents. Snyder has proposed using up to half the money saved by this federal funding takeover for a health savings account to pay the state share of Medicaid expansion, beginning with $103 million in the 2014 budget.
Additional savings from Medicaid expansion would come in the form of lower health insurance premiums. Currently, an uninsured person who needs health care goes to a hospital emergency room. By that time, they may be in poor condition, requiring expensive treatment. This uncompensated treatment is paid for in the form of higher insurance premiums for those with health care coverage, amounting to a hidden tax.
Medicaid expansion is now up to the Legislature, and Snyder needs bipartisan support for approval. Ordinarily, we would expect virtually unanimous Democratic support. But while Democrats like the proposal and its effects, some are bitter towards Snyder over freeloading off unions.
Meanwhile, Republicans are split, with a majority of them likely to be opposed. One such extremist opponent is state Sen. Patrick Colbeck (R-Canton), who doesn’t think the Affordable Care Act is a done deal and isn’t convinced that it will ever be fully implemented. Colbeck needs a reality check. With the law upheld by the Supreme Court and President Barack Obama re-elected, it is here to stay. In the state House, Rep. Gail Haines (R-Lake Angelus), who chairs the Health Policy Committee, is willing to face up to reality, while Speaker Jase Bolger (R-Marshall) has been cautious and non-committal.
The bottom line on Medicaid expansion is that it can improve the health and well-being of thousands of Michigan residents, at little taxpayer expense. As such, it deserves to be approved. All that matters is the effect it will have on people’s lives. It doesn’t matter if Snyder is doing the right thing for the wrong reasons.