Republican Gov. Rick Snyder
signed a Medicaid expansion bill for Michigan Monday, contingent on necessary waivers from the federal government. Likewise, on Monday Republican Gov. Tom Corbett
endorsed a Medicaid expansion plan for Pennsylvania, another plan that would require federal waivers.
Michigan's proposal would require that recipients pay income-based premiums that could be reduced with healthy lifestyle choices, but increased if the recipient ends up being on Medicaid for more than four years. The Pennsylvania proposal would privatize the Medicaid dollars, subsidizing private insurance premiums for qualified recipients using the Medicaid dollars. Corbett would also require recipients to be actively searching for work. It would also apply cost-sharing to all Medicaid recipients, not just the people in the expansion.
Combined, if these proposals pass muster with the federal government, more than 800,000 people will be able to gain insurance that would otherwise be shut out. This also pushes the bare majority of states into the Medicaid expansion pot, as Sarah Kliff writes. But does it put Obamacare over the tipping point, as she says? Yes and no. Yes, more people could be covered and getting people covered has been the primary goal. But at what cost? One Pennsylvania activist sums it up.
"What's bad about it is that under the guise of reaching out to cover people with health insurance, they are going to take benefits away from an awful lot of people," said Richard Weishaupt, senior attorney at Community Legal Services of Philadelphia. "Welfare provides a mom and a kid $316 a month, and they get Medicaid. How in the world are they going to come up with $25 for health insurance?"
People already on Medicaid in Pennsylvania would have to pay more, perhaps making insurance ultimately out of reach, and jump through work search requirement hoops. People hoping to be on Medicaid in Michigan would have to be answerable to the government for their lifestyle choices and with a ticking clock. These Republican governors are apparently only willing to help their uninsured constituents if they can simultaneously punish them for needing the assistance.