Medicaid expansion appears to face as many obstacles in the state Senate as it does in the state House.
In Tuesday's edition of the Lansing insider political newsletter MIRS, Senate Majority Leader Randy Richardville, R-Monroe, said there would be no expansion of Medicaid in Michigan unless the federal government is willing to grant a waiver for the reforms state Republican lawmakers want, such as a 48-month cap on benefits and a small co-pay.
In essence, Sen. Richardville's message was that the Senate was approaching the issue with as many reservations as the House and perhaps more cautiously. In fact, Capitol Confidential has learned that it's doubtful Senate Republicans will propose any form of Medicaid expansion.
The expansion is the key issue pertaining to Obamacare that state lawmakers face this year. The administration of President Barack Obama is trying to get states to expand Medicaid and offering a hundreds of millions of dollars as an enticement. It is estimated that Michigan would save $200 million in the upcoming fiscal year if it expanded Medicaid and took the short-term money.
Groups in the conservative base prefer that lawmakers not even flirt with the idea of expanding Medicaid. Last week, House leaders outlined Medicaid reform legislation as House Bill 4714, which included Medicaid expansion with a number of caveats that would require federal waivers that seem unlikely to be granted.
Sen. Richardville was asked about the possibility that the federal government would deny the waivers the House plan would require.
In response, MIRS quoted Sen. Richardville as saying, "Well, I guess we'll say, 'No way.' And I guess we'll move on to something else."
On Wednesday, Capitol Confidential asked Sen. Richardville to comment on what appears to be an "our deal or no deal" stance.
"We've been conservative and realistic and we are very conscious of the fact that we are responsible for how Michigan taxpayers' dollars are allocated," Sen. Richardville said. "That's not going to change just because there's a proposal that throws money on the table.
"I don't believe that you solve problems by unilaterally throwing money at them," Sen. Richardville continued. "I think we've all learned that from examples in the past."
Before last week's announcement of the House plan, a GOP workgroup had been discussing the issue. It consisted of Sen. John Moolenaar, R-Midland; Sen. Mark Jansen, R-Grand Rapids; Rep. Al Pscholka, R-Stevensville; and Rep. Matt Lori, R-Constantine.
Sen. Moolenaar was firm in his commitment in Michigan getting a waiver from the federal government.
"I can't speak for any lawmaker other than myself," Sen. Moolenaar said. "But it seems pretty clear that any legislative proposal to expand Medicaid without getting a waiver from the federal government doesn't have support in the legislature.
"I have serious reservations about Medicaid expansion," he said. "What I've recommended is that the Legislature shouldn't take any votes on it until after we know whether or not the federal government would even grant a waiver."
Complicating the issue further, a recent study published in the New England Journal of Medicine by some of the nation's top health care economists found that Medicaid has "no significant effect" in health outcomes. The study was the most comprehensive done to date on Medicaid coverage.
It is unclear whether there will be enough support in the House to pass House Bill 4714. If a vote on the bill were to eventually take place, it is believed it wouldn't happen until after the Detroit Regional Chamber's Mackinac Policy Conference. That event is scheduled for May 29-31 on Mackinac Island.