GOP Controlled Legislature Passes Medicaid Expansion; Headed to Governor for Signature State Rep.: 'Medicaid does not offer the best option of care for the expanded population'

Medicaid expansion in Michigan, which is a key to the implementation of Obamacare, is now headed to Gov. Rick Snyder for his signature.

The state House on Tuesday voted 75-32 to concur with the state Senate's version of House Bill 4714, which will expand Medicaid to able-bodied adults without children in Michigan. Gov. Snyder has lobbied extensively for the expansion and has said he will sign the bill.

Michigan will be the 25th state to expand Medicaid; 21 states have refused. It is estimated that more than 300,000 people will be added to the social welfare health care program in Michigan.

Among Republican House members, 28 voted for the bill and 31 voted against it. Democrats supplied 47 of the "yes" votes. All but one of the Democrats voted "yes."

Rep. Greg MacMaster, R-Kewadin, was the only House member to change his vote to "no" on Tuesday after voting "yes" in June. Rep. Gail Haines, R-Waterford, was absent when the June 13 vote was taken. She voted "yes" on Tuesday. The lone Democrat who voted "no," was Rep. Scott Dianda, D-Calumet.

When the final votes were tallied in both houses, 49 Republican senators and representatives voted "no" on the final version of House Bill 4714, while 36 voted "yes."

"Every Republican legislator, including ones who voted 'no' on the expansion, shares some of the responsibility for this," said Jack McHugh, senior legislative analyst with the Mackinac Center for Public Policy. "Had they been willing to buck the governor and raise a ruckus in their own caucuses, they could have prevented a speaker and majority leader they themselves selected from using the votes of Democrats and a minority of Republicans to roll their own caucuses.

"They weren't willing to do those things, which fully explains this vote," McHugh added. "No Republican legislator can feel comfortable about a critical Obamacare implementation measure being adopted on his or her watch."

There were no efforts to amend the legislation Tuesday and no real debate on the House floor. Only one legislator, Rep. Ed McBroom, R-Vulcan, who voted against expansion, spoke on the bill.

"We should all remember that Medicaid does not offer the best option of care for the expanded population," Rep. McBroom said. "I've been on Medicaid and so have members of my family. It is not easy and it is not a great option. We seem to be focused on the overall numbers and overall dollars rather than the quality of care provided. This issue is coupled with the insipid insinuation that providing Medicaid to the expanded population will dramatically change the usage of emergency rooms for primary care. I think this is a ludicrous presumption.

"Helping the most in need in our state is a good investment, whether it saves the state money or not," Rep. McBroom continued. "The problem is, we only have so much to utilize for this. The feds only have so much to invest and one could argue, with their debt and deficits, they don't really have any at all. I believe we are pledging more than we can afford and am confident the federal government is pledging far, far in excess [of] what it can afford. The insolvency of Medicaid, long term, for the federal government is clearly apparent and will drag us down if we are attached to it. It will be hugely more expensive and expansive than is currently being discussed, which will further accelerate the insolvency."

Once signed into law, Michigan will receive billions in up front dollars from the Obama administration. The federal government has pledged to pay for the first three years of the expansion. After that, the state will start bearing an increasingly larger share of the cost.

Proponents of House Bill 4714 claim the bill was crafted in a manner that would allow the state to undo the expansion in the future over issues of funding or if the federal government refuses to allow reforms. Critics of the expansion argue that this is an unrealistic claim devised as a short-term cover story.

Because the bill failed to get enough votes in the Senate to give it immediate effect, Medicaid expansion in Michigan will begin April 1, 2014, instead of Jan. 1, 2014.

"I would have preferred to have gotten immediate effect, but what I would say is this is still a victory for Michiganders — both in terms of the people getting coverage and all Michiganders," Gov. Snyder told reporters.

The 28 Republicans who voted "yes" were Speaker Jase Bolger, R-Marshall, and Reps.: Mike Callton, R-Nashville; Hugh Crawford, R-Novi; Cindy Denby, R-Handy Township; Anthony Forlini, R-Harrison Township; Frank Foster, R-Pellston; Ben Glardon, R-Owosso; Gail Haines, R- Waterford; Joe Haveman, R-Holland; Brad Jacobson, R-Oxford; Klint Kesto, R-Commerce Township; Eileen Kowall, R-White Lake; Andrea LaFontaine, R-Richmond; Matt Lori, R-Constantine; Lisa Lyons, R-Alto; Mike McCready, R-Bloomfield Hills; Margaret O'Brien, R-Portage; Dave Pagel, R-Oronoko Township; Earl Poleski, R-Jackson; Amanda Price, R-Holland; Al Pscholka, R-Stevensville; Bill Rogers, R-Brighton; Wayne Schmidt, R-Traverse City; Mike Shirkey, R-Clarklake; Jim Stamas, R-Midland; John Walsh, R-Livonia; Ken Yonker, R-Caledonia; and Dale Zorn, R-Ida.

(Editor's note: This story has been updated with new information since its original posting.)

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See also:

Eight Senate Republicans Join Democrats In Passing Obamacare Medicaid Expansion

New Medicaid Study: 'Waivers Are Temporary, Expansion Is Forever'

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The Real Patients of Medicaid: Teraca

Medicaid Recipient: 'When I ask where I'm suppose to go, I'm told the hospital'

'ER Visits Won't Increase' Claim By Medicaid Expansion Advocates Remains Dubious