IE 11 is not supported. For an optimal experience visit our site on another browser.

Medicaid advances in Michigan after late-night drama

In February, Michigan Gov. Rick Snyder (R) endorsed expanding Medicaid coverage under the Affordable Care Act, which would bring health care coverage to about
Michigan Gov. Rick Snyder (R)
Michigan Gov. Rick Snyder (R)

In February, Michigan Gov. Rick Snyder (R) endorsed expanding Medicaid coverage under the Affordable Care Act, which would bring health care coverage to about 470,000 low-income Michiganders who would otherwise go without. It was an easy call for Snyder to make, but persuading the Republican-led state legislature would take more effort.

In June, Medicaid expansion cleared the state House, but the bill appeared stuck in the state Senate. Last night, however, after some unexpected drama, the measure passed.

The fierce struggle among Republicans over whether to make Medicaid available to more low-income people played out in Michigan on Tuesday as the Republican governor, Rick Snyder, narrowly succeeded in swaying enough conservative senators in the State Legislature to accept the expansion, which was part of President Obama's health care law.Mr. Snyder's preferred bill -- one he had lobbied for intensely for months -- initially fell short by one vote, but the governor salvaged a deal hours later. The vote in the Republican-controlled Senate was 20 to 18, with only 8 Republicans in favor. The Michigan House, which had earlier approved a similar measure, will need to vote on the Senate version before Mr. Snyder can sign the bill.

Snyder said after the vote that the Affordable Care Act may be "divisive," but the governor asked the state to "step back and look to say this isn't about the Affordable Care Act."

No, of course not. It's just about part of "Obamacare" that some Republicans can apparently tolerate.

The debate in Michigan quickly became a microcosm of the broader national fight -- proponents of the policy noted Medicaid expansion would cover hundreds of thousands of uninsured people, boost the state economy, and even save Michigan money. Opponents said government is bad, and measures that save money might someday secretly cost more money. (I didn't say it was an intelligent debate; I said it was a microcosm.)

The back and forth in Michigan continued for months, leading up to last night's dramatic developments.

The state Senate debated for more than eight hours, and actually balked at the Medicaid proposal, at least at first. Dylan Scott had a good summary:

The bill needed 20 votes out of the 38-member Senate to pass. On its first vote at about 5:30 p.m., it received 19 yea votes and 18 nay votes in a floor vote, but Republican Sen. Patrick Colbeck, who is vehemently opposed to expansion, abstained from voting. If he had cast a nay vote, leaving a 19-19 tie, then Republican Lt. Gov. Brian Calley could have cast the tiebreaking vote to pass the bill, as Calley has pledged to do.But because Colbeck didn't vote, the bill failed when it didn't reach the 20-vote threshold. The Senate then immediately voted 21-17 to reconsider the vote and went into recess so the party caucuses could meet. It took more than two hours before the Senate reconvened and finally passed the bill.Sen. Tom Casperson, a Republican, switched his vote after securing an amendment that reformed hospital payments for uncompensated care for the uninsured. According to tweets from local reporters, Casperson had been expected to vote for the expansion initially, but unexpectedly voted nay on the first floor vote. His yay on the second floor vote made Calley's tiebreaking vote unnecessary.

Because minor changes were made to the Senate version, the state House will have to take up the measure again, though most Michigan observers expect it to pass.

Michigan joins Arizona and North Dakota as states run by Republicans which nevertheless approved Medicaid expansion. Ohio and Virginia may yet join the club.

Update: Jonathan Cohn, who's in Michigan, has a great piece on yesterday's developments and their significance.