Medicaid Expansion Comes to Michigan


On Tuesday, September 3, the Michigan House of Representatives voted 75 – 32 to expand Medicaid to adults in Michigan with incomes at or below 133 percent of the federal poverty level (FPL). The final legislation—HB 4714, which passed in the Senate on Tuesday, August 27—also includes reforms to the existing Medicaid program, such as new cost-sharing requirements and incentives for health living. Unfortunately, the legislation passed both chambers without a procedural device known as “immediate effect.” Essentially this means, absent any further action, the earliest the provisions could be implemented is March of next year and the state could lose out on hundreds of thousands of dollars towards health care coverage for low income patients.

On Monday, September 16, Governor Rick Snyder signed the bill into law during a press conference held at Oakwood Hospital in Dearborn. MAFP leadership and staff joined Governor Snyder after he signed the legislation and thanked him, and our legislators, for their relentless positive action to ensure a Healthy Michigan. (Pictured to the right from left to right: MAFP Chief Executive Officer Debra McGuire; MAFP President-elect Tina Tanner, MD; Governor Rick Snyder; MAFP Vice President Kim Yu, MD, FAAFP; MAFP Director of Government Affairs Christin O’Brien; and MAFP Communications Coordinator Annie McIntosh). This event concludes months of advocacy efforts on the side of MAFP in concert with the Expand Medicaid Coalition. Many MAFP members donated their time to attend events with the Governor and lawmakers or travel to the Capitol to demonstrate their support for the bill. And, on behalf of all of us at MAFP, we sincerely thank you for all of your efforts!

But why support the expansion of Medicaid coverage, which has become so politically polarizing, in large part, due to its ties with the Affordable Care Act (ACA)?  Well, Family Physicians witness, first-hand the critical impact health care coverage and access to care have on people in the communities where they practice. Collectively, the Family Physicians of MAFP provide tens of millions of dollars in uncompensated care each year to individuals who have no health insurance and cannot afford regular primary care. But, charity alone cannot assure access to regular, affordable care for nearly half of Michigan’s 1.1 million residents who are currently uninsured. Extending Medicaid coverage to roughly 450,000 low-income adults will seek to alleviate some of these challenges.

While this is a great victory for many in Michigan, there is still more we can do. As we consider future realities, such as an aging population and the expansion of health care coverage, MAFP will be diligently advocating for policies that help attract and retain the primary care physician base we need to meet the state’s growing demand. In particular, MAFP supports efforts that will improve access to Family Physicians through expanded opportunities for loan forgiveness programs, delivery system and payment reform and graduate medical education reforms that train more Family Physicians to practice in Michigan.

While the passage of this legislation is a step in the right direction toward improving both the physical and financial health of patients, families, businesses and communities throughout the state, it is only through similar steadfast efforts that we can address challenges—such as closing the health disparity gap to ensure everyone has access to a Family Physician—head on.