Snyder Administration Pushing To Distance Medicaid Expansion From Obamacare

Originally, Obamacare included the expansion of Medicaid to help cover some of the nation's uninsured, but the U.S. Supreme Court said that was unconstitutional.

So, now the federal government is using money from the Obamacare bill to entice states to expand it on their own, says one health policy expert.

With that in mind, a recent tweet from the staff of Michigan Lt. Gov. Brian Calley raised the eyebrows of Cato Institute's Mike Tanner, who wrote a book on Obamacare. Lt. Gov. Calley said the debate on Medicaid expansion is about reforming the system and is not linked to Obamacare.

"This is reform of our Medicaid system. Classifying it as 'Obamacare' is inaccurate," a Snyder administration staffer tweeted Lt. Gov. Calley as saying on July 2.

But Tanner says Obamacare is picking up the tab for any Medicaid expansion.

"The question to ask him (Lt. Gov. Calley) is: 'Would Michigan be taking these actions in the absence of Obamacare promises for future funding?' " Tanner said.

The reason states around the country are debating the expansion of Medicaid is because the Supreme Court found that the Patient Protection and Affordable Care Act's (commonly referred to as Obamacare) mandate of Medicaid expansion was unconstitutionally coercive of states, according to the Kaiser Commission on Medicaid and the Uninsured. 

As of July 1, 21 states were not moving forward on Medicaid expansion and six others were still debating it, including in Michigan. 

Tanner said Obamacare planned to use Medicaid expansion as a way to get many of the uninsured insurance. He said as many as 12 million of the 27 million uninsured would have received insurance through Medicaid expansion in the country.

However, because of the Supreme Court's decision, the federal government could only ask the states to expand Medicaid and then offer those that did money to cover the costs, at least initially. Tanner said the federal government enticed Michigan by increasing from about 45 percent of funding of Medicaid to funding 100 percent of the expansion and then sliding it back down to 90 percent. Tanner said that funding is found in the Obamacare bill.

"So I don't see how you can say it (Medicaid expansion) is not part of the law," Tanner said.

Sara Wurfel, spokeswoman for Gov. Rick Snyder, said Medicaid expansion is part of a plan to control costs for what the governor's office is calling, "Healthy Michigan."

“Healthy Michigan does not comply with the traditional Medicaid rules that the ACA envisioned expanding, which is why this is a Michigan solution designed by Michigan policy makers for Michiganders," she said. "It requires waivers from existing federal rules to be implemented. That's a significant distinction. This plan makes reforms to the Medicaid program that controls costs by focusing on personal responsibility and wellness, reduces the burden of uncompensated care that shifts costs onto businesses and taxpayers, and helps our citizens access affordable care."

Jack McHugh, senior legislative analysis at the Mackinac Center for Public Policy, said the ongoing Medicaid debate in Michigan is certainly part of Obamacare.

"Oh please, any 'reforms' the Obama administration is likely to approve will represent marginal changes to a massive welfare program," McHugh said. "Associating them with Medicaid expansion is primarily a cover story for Republicans worried about political retribution from their base, who regard voting to implement Obamacare as a profound contradiction of all their campaign rhetoric.

"We already have congress inventing Orwellian titles like the 'Patient Protection and Affordable Care Act,' and the mainstream media willing to look like pompous elitists with their formulation, 'the federal health care law called 'Obamacare' by opponents'," McHugh said. "Now we have state Republican politicians playing these games? I say, take back the language! The proper labels for these things are: 'the law called 'Obamacare' by real people,' and 'the Obamacare Medicaid expansion.' "