Michigan Gov. Rick Snyder on Wednesday called for extending Medicaid eligibility to hundreds of thousands of state residents without health insurance, welcoming the option available under the Obama administration's healthcare overhaul.
Snyder, a Republican, made the announcement at a Lansing hospital the day before he proposes his next state budget.
"It's a win for all," he said while flanked by doctors, nurses and health officials.
The chance to cover nearly half of the state's uninsured is "huge," Snyder said, adding that he is comfortable the healthcare system can handle the extra caseload.
The federal healthcare law gives states the option to accept the expansion, refuse it or postpone a decision. But there are benefits for states that choose to expand Medicaid.
The federal government will pick up the entire cost in the first three years and 90% over the long haul.
Snyder is expected to run into resistance from Republican lawmakers opposed to the health law. Hospitals, doctors and others in favor of Medicaid expansion joined Snyder at his announcement.
He said Medicaid expansion would save the state $200 million a year initially because more people who now receive mental health services and medical care from state-funded programs will instead be covered with federal money. He called for setting aside $100 million a year of those savings so Michigan can kick in for new enrollees down the line.
This is the second time in less than 18 months that Snyder has bucked his own party on a major healthcare question.
His call to implement a state-run online marketplace where the uninsured can get taxpayer-subsidized private coverage died in the GOP-controlled Legislature. Michigan now is on the path toward a partnership exchange controlled primarily by the federal government.
In 30 states led by Republican governors, six governors have called for enlarging Medicaid. Ohio's John Kasich earlier this week reiterated his opposition to what he called "Obamacare" and the requirement that people have health insurance but said expansion makes sense for Ohio.
By expanding Medicaid in 2014, Michigan could add about 470,000 people to a program that already serves about one in five state residents.
Three years of full federal funding for newly eligible enrollees are available from 2014 through 2016, gradually phasing down to 90% in 2020 and after. The match rate for existing Medicaid participants is 66%.
To qualify, household income must be below 138% of the federal poverty level, about $15,000 for an individual.
Conservatives are concerned deficit-burdened Washington will renege on the 90% deal and also have a philosophical resistance to expanding government programs, particularly one as large as Medicaid.