MichiganVotes: New Bill Starts Discussion Of Medicaid Expansion Alternatives

Sen. Patrick Colbeck, R-Canton, has introduced the first of two bills aimed at finding a free-market alternative to Medicaid expansion.

The stated goal of the legislation is to increase access to quality care without expanding government.

In the press release announcing the measure, the legislation, Senate Bill 459 and a yet to be introduced companion bill, is described as a "patient-centered solution" offered in place of Medicaid expansion.

On Thursday, Sen. Colbeck presented his plan to a Senate workgroup that's seeking a solution to Michigan's Medicaid expansion issue. This workgroup was set up by Senate Majority Leader Randy Richardville, R-Monroe, after he refused to immediately take up House Bill 4714, the Medicaid expansion bill that passed the House with Democrats providing most of the "yes" votes along with 28 Republicans.

Gov. Rick Snyder wanted the Senate to pass the bill quickly, but Sen. Richardville didn't bring it up for a vote because a majority of Senate Republicans didn't support it.

The administration of President Barack Obama wants states to expand Medicaid to accommodate the implementation of Obamacare. It is using billions in up front federal dollars as an enticement for states that do so.

Sen. Colbeck's measure would not expand Medicaid. Michigan would not qualify for the money being offered by the Obama administration if his bill was enacted.

Gov. Snyder is holding town hall meetings around the state in an attempt to stir up support for some form of Medicaid expansion. However, Gov. Snyder isn't calling it "Medicaid expansion." He's calling it, "Healthy Michigan," and more recently, "Medicaid reform."

Taking his cue from Gov. Snyder’s choice of words, Sen. Colbeck had Senate Bill 459 drafted. It would be Medicaid reform without expansion.

"We made a case for this," Sen. Colbeck told Capitol Confidential, referring to his presentation to the Senate work group. "Now it will be up to them. But this was just the first step. I think the next step will be to have the Senate Fiscal Agency look it over and I'd like to have a national policy research center have input on it as well. We want to get this in juxtaposition next to the other plans."

Jack McHugh, senior legislative analyst with the Mackinac Center for Public Policy, said the legislation, as currently drafted, injects some free market ideas into Michigan’s ongoing health care debate.

"The underlying cause of medical inflation is third-party payment systems that mean consumers don't have skin in the game, because it's always someone else paying the bills," McHugh said. "The bill looks like an effort to break that dynamic by removing regulatory obstacles to direct, contractual relationships between doctors and families via service plans with low monthly costs. Plus, it would use high-deductible insurance policies to cover non-routine, catastrophic expenses.

“It's ambitious to try this at the state level — perhaps too ambitious — and it's probably not possible under an Obamacare regulatory regime," McHugh continued. "Obviously this is bigger than just the Obamacare Medicaid expansion and, if nothing else, may stimulate some interesting and constructive conversations."

Sen. Colbeck explained the companion bill that goes along with Senate Bill 459.

"That bill takes the existing Medicaid enrollees and puts them in a primary care plan," he said. "A Health Savings Account (HSA) part is wrapped in with this. The hope is to use state money to provide better care and prime the pump for a very robust primary care market in Michigan."

According to a Sen. Colbeck news release, the bill would provide a "regulatory infrastructure that would enable a low cost, high quality care, free market environment within the confines of the Affordable Care Act (ACA) [Obamacare]."

"We need to stop talking about expanding a government program that doesn't work and start talking about ways to expand affordable care to all of our citizens," Sen. Colbeck said. "We can use this as an opportunity to put in place a free market based system that will not only accomplish the stated objectives of Obamacare but will also establish Michigan as a destination state for employers seeking quality, affordable health care for their employees."