Michigan Governor Rick Snyder is requesting an additional Medicaid expansion for all people under 21 in Flint regardless of income or prior insurance in order to provide adequate and lower-cost services for young people who may have been affected by the lead crisis. Detroit Free Press reports:
Specifically, the initiative, which is expected to be sent to the Obama administration in the next week, seeks expanding Medicaid eligibility to those affected regardless of income level. The request would also include the expansion of Medicaid coverage for people already enrolled in other forms of insurance.
The idea, state officials said, is to spread comprehensive benefits to children who may have come into contact with lead in the water regardless of their ability to pay. Generally, lead affects children more than it does adults. Children tend to show signs of severe lead toxicity at lower levels than adults, according to the federal Centers for Disease Control.
In addition, the state would ask for additional resources to bolster community-based services to address behavioral issues arising from lead exposure. Finally, additional resources would be poured into removing lead from Flint homes through an expanded Medicaid match program.
While Michigan has expanded Medicaid services to low-income healthy adults under the Healthy Michigan program and the Affordable Care Act—and was one of the first states with Republican leadership to do so—political wrangling over the issue and foot-dragging may have cost the state in the early going. Snyder is now a full-throated proponent of the original expansion, and its injection of funds into the state probably helped on that. The expansion currently covers childless adults up to 138 percent of the federal poverty level and parents at certain levels with copayment, while traditional Medicaid covers other groups under poverty.
Snyder is again asking for an injection of federal funds with this proposed expansion in addition to the emergency funds and $80 million approved by the Obama administration. However, the Medicaid expansion for affected youth in Flint may not be adequate from a public health perspective because of the wide range of services that may be required—since lead damage is permanent in many cases—into adulthood for some cases. The details of the plan are currently murky, but they would require some maneuvering around Michigan’s existing waiver and the established rules of the program.