Note To Our Representatives: Support Medicaid Expansion!

By Tom Watkins

Governor Snyder made the morally and fiscally correct decision to ask the Michigan Legislature to expand Medicaid in his budget. As it stands today, the Legislature is rejecting his reasonable request. The House Appropriations Subcommittee removed Medicaid expansion from their budget, and it is reported that the Senate will this week report their budget without Medicaid expansion as well.

There are many reasons the Michigan Legislature should follow Governor Snyder’s lead. Let me count the ways:

1. It is simply sensible, public policy to tap federal funds already set aside to expand preventive and lifesaving health care under Medicaid. Medicaid expansion represents the best single opportunity to improve access to behavioral healthcare services for Michigan citizens most in need, and is deserving of legislative support
2. Cuts to general fund support for mental health and substance use disorder services over the past decade have resulted in a lack of access, reduction of services, and creation of waiting lists for persons without Medicaid. As a result, persons with emerging mental health and substance use disorders are not seen for care. Instead, they end up in emergency room and hospital settings, where their cost of care is 20 times greater. They also often find themselves subject to law enforcement and criminal justice proceedings and/or simply homeless, none of which provide the mental health and substance use care they need.
3. Since the tragic Newtown, Connecticut massacre, mental health services have taken a much-needed front seat in policy and budget discussions at both the state and federal levels. Far too often, obvious needs for treatment are not met due to long waiting lists at local community mental health service agencies. The Governor has proposed increases in mental health funding as a part of the Medicaid expansion proposal. The best way to remove barriers to care and expand mental health services is to expand Medicaid.
4. Medicaid expansion would provide coverage options for small businesses and create a healthier work force that will improve the state’s economic competitiveness. Workers at many small Michigan companies do not get insurance from their employers. Medicaid expansion will cover low-wage working adults: Michigan workers with no health insurance and too little income to afford coverage.
5. Currently, Michigan hospitals end up providing more than $880 million a year in uncompensated care to patients who are unable to pay. It is estimated that up to $1,000 of the annual cost of a health insurance premium for a family of four is to cover this uncompensated care. Expanding Medicaid as Governor Snyder recommended will reduce this hidden, “health care tax” paid by insured individuals, families and businesses.
6. The Governor’s recommendation would also help local community hospitals. Because the federal government wishes to expand Medicaid via health insurance exchanges, local hospitals stand to lose reimbursements for uncompensated care. If Michigan Legislators do not support Medicaid expansion, they jeopardize the financial stability of local hospitals across the state.
7. If Michigan’s Legislature fails to expand Medicaid coverage, an opportunity to provide health insurance for thousands of hard working, low income residents across the state will be lost but their needs—and costs—will remain.
8. The federal government, which is asking states to expand Medicaid coverage, has pledged to cover the full cost of expansion through 2016 before gradually reducing funding to 90 percent by 2020.
9. Governor Snyder has been extremely clear in his belief that the expansion will help protect over 300, 000 of Michigan’s most vulnerable citizens in the next year alone, decrease the rate of emergency room visits that drive up health care costs for everyone, and save the state millions a year in state spending—half of which he wants to put into a savings account to offset any future costs.
10. Finally, it is estimated that Medicaid expansion will create 18,000 new health care jobs and generate $2.1 billion in new economic activity in Michigan.

When Governor Rick Snyder called for expanding Medicaid under the federal Affordable Care Act, he said, “This makes sense for the physical and fiscal health of Michigan.” He continued, “Expansion will create more access to primary care providers, reduce the burden on hospitals and small businesses, and save precious tax dollars. It also puts Michigan rather than Washington in the driver’s seat in terms of implementation, which allows us to better address Michigan’s specific needs.”

The time is now to call on the Michigan Legislature to support Governor Snyder’s proposals to expand Medicaid coverage for Michigan families making less than 138 percent of the federal poverty level. For all of the reasons outlined above—and many more—it is irresponsible for the Legislature to not support the Governor’s proposal.

Let’s remember: Supporting Medicaid expansion is about helping real people—our families, neighbors and friends—with real needs by tapping the tax dollars we send to Washington. It is a wise investment.

Tom Watkins served the citizens of Michigan as state superintendent of schools and state mental health director under Democratic and Republican Administrations. He can be reached at tdwatkins88@gmail.com