LANSING, Mich. (AP) -- Hundreds of thousands of more low-income adults in Michigan would become eligible for government-funded health insurance under legislation backed Wednesday by a divided House committee.
The 9-5 vote, which came after months of talks in the Republican-controlled Legislature over expanding Medicaid eligibility, set the stage for a possible vote Thursday in the House. Republican Gov. Rick Snyder is pushing hard for Medicaid expansion before legislators break for the summer at the end of next week.
The bill would expand Medicaid to 320,000 nondisabled adults in 2014 and more in following years.
Under the federal health care overhaul, states can expand Medicaid to adults making up to 133 percent of the poverty level, which is about $15,300 for an individual. The federal government is offering to cover the entire cost initially and 90 percent down the line.
The bill includes GOP-written requirements that new enrollees pay some of their medical expenses and pick up more costs after being on the program for four years. The federal government would have to sign off for Michigan to proceed with its plan.
Supporters say offering health insurance to more poor people will make them healthier and minimize their expensive trips to the emergency room, saving money. Opponents say it is a bad idea to undertake a massive expansion of government even if the federal government will pay most of the costs. A group of tea party and conservative activists said Tuesday that they would oppose Snyder's expected re-election bid because he has pushed to expand Medicaid coverage.
Four Republicans and five Democrats on the House Michigan Competitiveness Committee voted for the legislation. Four Republicans opposed it.
Committee Chairman Mike Shirkey, R-Clark Lake, said he was a "hard no" when Snyder initially proposed Medicaid expansion, but he changed his mind.
"I evaluated the downsides, what would actually happen to the state if we did nothing," Shirkey said. "Things like not being able to address this growing problem of uncompensated care. Things like Michigan being a huge donor state in terms of the new taxes associated with the Affordable Care Act. Those are the kind of things that I said, 'You know what. We cannot afford to not step up and address those.'"
Medicaid covers roughly one in five Michigan residents -- mainly low-income children, pregnant women and the disabled along with some poorer working adults.
Working parents in Michigan currently qualify for the taxpayer-funded insurance if they earn up to about half the poverty line, $11,800 for a family of four. Nondisabled adults without children who make less than 35 percent of the poverty level, or $4,000 for an individual, also get Medicaid -- although the program generally is closed to new participants.
An estimated 320,000 state residents -- many of them adults without children -- could be added to Medicaid in 2014 and 470,000 by 2021, cutting the state's uninsured by nearly half. Uninsured residents with higher incomes will be covered by a federal insurance marketplace offering taxpayer-subsidized private plans.
The legislation no longer includes a hard, 48-month time limit for adults added to the government health insurance program. Instead, those adults ages 21 to 64 would have two options after four years: buy government-subsidized insurance through an exchange or stay on Medicaid by paying more out-of-pocket costs.
The time limit was touted as the first such proposal in the country when it was introduced a month ago. But it had drawn concern from Republican Gov. Rick Snyder, Democrats and advocates for the poor.