More misinformation -- Medicaid expansion not a permanent decision

By Chad Selweski
chad.selweski@macombdaily.com; @cbsnewsman
Wednesday, August 28,2013

As Republican conservatives and tea party activists rail against state Senate approval for a Medicaid expansion, it appears that one of the primary criticisms of the legislation was based on false information.
Many Republican lawmakers in the House and Senate had argued forcefully for months that the federal government may renege on its promise to provide most or all of the expanded Medicaid funding for health care coverage. Critics in the state Capitol said that Washington could pull the plug, leaving Michigan with huge financial burdens to fund the broader version of Medicaid planned under the White House’s Obamacare plan.

But a key health care reform expert, plus Snyder administration officials, say that Michigan can immediately bow out of the Medicaid plan if lawmakers believe the federal government is not living up to its promises.
“States can opt in or opt out of the expansion at any time,” said Jennifer Tolbert, a policy analyst for the nonprofit, nonpartisan Kaiser Family Foundation research organization.
In fact, U.S. Health and Human Services guidelines have specified that no state is locked into a Medicaid expansion for the “working poor,” no matter the political or fiscal circumstances in the future.

The Snyder administration asserts that is has been trying to shoot down claims by lawmakers about signing on to an expensive health care plan that could drop some or all of the costs into the lap of Michigan legislators — and ultimately the taxpayers.
“That is one of the myths we have been trying to combat,” said Angela Minicuci, spokeswoman for the state Department of Community Health. “There are a number of misconceptions about this legislation.”

As the 20-18 Senate vote on Tuesday in favor of the Medicaid expansion appears to have eliminated the last political hurdle, some legislators may want to do some Monday morning quarterbacking to determine if the bitter fight over the legislation was based on a false premise. The idea that this was a landmark vote with far-reaching implications may have been off the mark.
The Obama administration is offering 100 percent funding for expanding the state’s Medicaid coverage to families at 133 percent or less of the federal poverty level — or $26,900 annual income for a family of three. That promise will gradually slide to a 90 percent commitment in 2020 and is expected to remain at that level for the foreseeable future.

Tolbert, a key expert at Kaiser, one of a small group of research groups that has been labeled an objective source of information on Obamacare, said that the only penalty paid by the Michigan Legislature if it pulled out a year from now would be a political one — offering and then rescinding low-cost health care coverage for 470,000 poor Michigan residents.
The same false argument that the federal government would lock in Medicaid expansions was used in a number of Republican-dominated states, according to Tolbert. She said some of the claims were unintentionally misleading, while other cases “it was willful to put forward a political argument.”

As the Michigan House prepares to grant final approval to the Medicaid plan as early as Tuesday, embracing the Senate’s revised version of a House bill passed in June, one major issue remains.
Democratic advocates of the new Medicaid system want to encourage the House and Senate to muster two-thirds supermajorities to give the bill immediate effect. If that fails, the new system would not kick in until 90 days after the start of the new year in 2014.