LANSING, Mich. (AP) — The Michigan Senate adjourned Tuesday without voting to expand Medicaid eligibility to hundreds of thousands of low-income adults under the federal health care law, leaving the bill's future in doubt before lawmakers break for the summer.
After meeting for nearly seven hours, the Republican-dominated chamber put off a vote until Wednesday or Thursday, if one occurs at all.
It is believed the legislation could win approval if a vote is called, but traditionally the Senate leader will not hold a vote without at least half of the 26-member GOP caucus in support of proceeding with a vote.
"The majority leader's not going to change that practice on this issue," said Amber McCann, spokeswoman for Senate Majority Leader Randy Richardville, R-Monroe. "At this point we're going to wait until the majority leader feels he's ready to bring it up for a vote."
Just 12 Democrats sit in the Senate while the GOP-led House, which approved Medicaid expansion last week on a bipartisan vote, is more closely divided.
Other complicating factors that emerged Tuesday include whether the Senate would try to amend the House legislation — a delicate balancing act when trying to garner Republican and Democratic votes in both chambers — and concerns over whether the federal government would approve Michigan's plan.
Sen. Glenn Anderson, D-Westland, said he fears if a vote is not taken Wednesday, the issue will be pushed off until September.
"I think that'll be a fatal mistake," he said. "The fact is that some of the members on the (GOP) side that they may have been close to getting to vote 'yes' will come under a lot of pressure over the summer."
Conservative and tea party groups are pressuring lawmakers to oppose the expansion, including threatening to run candidates against some Republicans in 2014 primary elections. Republican Gov. Rick Snyder is pushing to provide more residents with the government-funded health insurance, saying it will make people healthier and save money because fewer uninsured patients will go to the emergency room for uncompensated care.
Medicaid covers roughly one in five Michigan residents, mainly low-income children, pregnant women and the disabled along with some poorer working adults. The bill would provide Medicaid to 320,000 more adults in 2014 and about a half-million by 2022, cutting the number of uninsured nearly in half.
Under the federal health care overhaul, states can expand Medicaid to adults making up to 133 percent of the poverty level, or about $15,300 for an individual. The U.S. government is offering to cover the entire cost initially and 90 percent down the line.
The bill includes GOP-written requirements that new enrollees making between 100 and 133 percent of the poverty line pay up to 5 percent of their income on medical expenses after being on the program for six months. They would have to contribute up to 7 percent of their income toward medical costs after getting Medicaid for four years.
Recipients could lower their premiums and copays, however, if they meet healthy behaviors such as not smoking. The 150,000 nondisabled adults earning between 100 and 133 percent of the poverty level would no longer be covered if savings from the expansion do not cover the state's future costs.
The federal government would have to sign off on waivers for Michigan to proceed with its plan.
Snyder is in Israel on a trade trip this week while Lt. Gov. Brian Calley is touring the Upper Peninsula — absences that drew criticism from Democrats eager to address a major piece of legislation.
"We've got it this far, and neither of them are here. That speaks to the problem within this administration," Anderson said.
Snyder spokeswoman Sara Wurfel said both trips had been on the books for more than five months based in part on the legislative calendar at the time.
"I think anyone who looks at this process objectively would have to come to the same conclusion: the governor has been 100 percent fully engaged and it's crystal clear that this is a high priority, despite peril from some of those in his own party," she said.
House Bill 4714: http://1.usa.gov/12nvl2W
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