Lansing — A House appropriations subcommittee advanced the 2014 Community Health budget Wednesday without money for Gov. Rick Snyder's proposed Medicaid expansion, a sign the proposal may be in jeopardy.
Snyder is among a growing number of GOP governors who have come out in support of the expansion despite party opposition to the federal Affordable Care Act. There is national debate about whether they'll be able to get their legislatures on board.
Michigan would be able to add 450,000 residents to its Medicaid rolls if the income limit for the program is expanded to 135 percent of poverty as allowed under the federal health care law.
The subcommittee voted 6-2 to approve an austere budget that also slashed funding for the Health Kids dental care program, infant mortality prevention and mental health services for veterans. The $15.3 billion plan is $1.3 billion smaller than Snyder's community health budget.
It now goes to the full House Appropriation Committee.
"The vote clearly indicates a strong reluctance on the part of Republican lawmakers to support something that an overwhelming majority of Republican voters apparently oppose," Jack Hoogendyk, an expansion opponent, said in a press release.
Rep. Matt Lori, chairman of the community health appropriations subcommittee, said there isn't a consensus in the Republican-controlled House to approve the Medicaid expansion.
Lori, a Republican from St. Joseph County,said he supports the expansion as a way to reduce the amount of uncompensated care hospitals provide. But he noted there are factors driving opposition, including concerns that Congress could cut the federal share and break its promise.
Snyder said Michigan will end up subsidizing other states that accept the expansion if the Legislature turns the proposal down. The federal government would pay 100 percent of the costs until 2017. Michigan's contribution would gradually increase to 10 percent by 2020, and then remain at that level indefinitely.
"My preference is to have Michiganders taking care of Michiganders, in terms of customer service," Snyder said.
Snyder also is facing challenges in the Senate, where legislation to authorize a federal health exchange partnership is foundering in a committee. The bill would authorize Michigan to enter into a partnership with the national government and to use a $30 million federal grant to help set up the exchange.
The governor met with the Senate Republican caucus in a closed-door session Wednesday, and appeared to remain optimistic.
"This is just part of the legislative process; there are usually challenges," Snyder said.
Detroit News Staff Writer Chad Livengood contributed.
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