Under the proposed waiver, residents above the federal poverty level who have been enrolled in Medicaid for 48 months would have to buy a private plan through HealthCare.gov or see their cost-sharing obligations rise to 7% of their income.
Under the current structure, beneficiaries with incomes between 100% and 138% of the federal poverty level pay 3% to 5% of their income for premiums and cost-sharing.
The terms of the request are dictated by the 2013 state law that allowed Michigan to expand Medicaid under the Affordable Care Act. The law stipulated that the request had to be submitted by Sept. 1, 2015, and that the CMS must respond by December 2015. If the CMS rejects the waiver, the state must terminate its Medicaid expansion program, dubbed Healthy Michigan.
Medicaid expansion still has the support of Republican Gov. Rick Snyder. “This governor doesn't play political games,” said John Truscott, a GOP consultant and president of Truscott Rossman public relations firm in Lansing, Mich. “This waiver request represents a very genuine effort to continue expansion in the state.”