August 28, 2013 at 3:19 pm

Sen. Casperson reluctant savior in Michigan Medicaid expansion vote

It was an amendment by Sen. Tom Casperson, R-Escanaba, who initially rejected the legislation, that resulted in a 20-18 vote for approval to expand Medicaid. (Dale G. Young / The Detroit News)

Lansing — Sen. Tom Casperson is surprised to have been cast in the role of Gov. Rick Snyder’s Medicaid expansion plan rescuer.

The Escanaba Republican, an opponent of President Barack Obama’s Affordable Care Act, switched sides amid a sometimes-bitter intraparty split to offer up the decisive vote allowing the plan to pass Tuesday night.

“It was quite a ride, to be honest with you,” he said from the Upper Peninsula home where he arrived about 3 a.m. Wednesday from a 387-mile drive following a nine-hour Senate drama. “I didn’t go down there with the idea it was going to go this way.”

He was among those praised by a relieved Snyder and Lt. Gov. Brian Calley at a press gathering after the governor’s proposed expansion of Medicaid to include more than 400,000 uninsured residents had been snatched from near-defeat.

“This was a big victory for bipartisanship,” said Calley referring to the winning coalition of 12 Democrats and eight Republicans who approved the plan. “They put aside politics and did the very best they could do” for Michigan.

Proponents fell two votes short of the two-thirds majority — or 26 votes — needed to give the bill immediate effect.

Implementation will be delayed until 90 days after the Legislature adjourns in late December, while federal law anticipates states will have their programs up and running Jan. 1.

But Senate backers will get another crack at immediate effect when the legislation comes back from the House next month.

House Speaker Jase Bolger, R-Marshall, said he anticipates a Sept. 3 vote on the Senate-passed plan, which contains acceptable revisions of the measure his chamber approved in June.

Casperson had been one of 18 “no” votes when the Medicaid plan appeared to have been rejected Tuesday afternoon in the Senate. The 19-18 tally was one short of the 20 votes necessary for a majority.

Sen Patrick Colbeck, R-Canton, had withheld his expected “no” vote in a strategic move. The non-vote prevented a 19-19 deadlock that, under Senate rules, Lt. Gov. Brian Calley would have broken by casting the 20th “yes” vote.

The passionate opponent of what detractors call Obamacare appeared to have handed Snyder another bitter pill.

Facing strong intraparty opposition, Majority Leader Randy Richardville had decided not to take a Senate vote on the House-passed plan before lawmakers broke for the rest of the summer in late-June.

He instead put Sen. Roger Kahn, R-Saginaw, in charge of a task force to hold discussions and draw up what would become the Senate’s version. Pundits looked at that as an uphill battle and wondered if Snyder had lost his clout.

The usually positive governor, visibly angered by the delay, embarked on a summer-long speaking tour to drum up public pressure in favor of Medicaid expansion.

But as Medicaid opponents congratulated each other Tuesday, Ricardville and Casperson were huddling to turn things around. And 2½ hours later, they had the deal that brought the “Healthy Michigan” plan back to life.

For his vote in favor of the bill, they would add an amendment prohibiting hospitals from charging uninsured patients more than 115 percent of what Medicare patients are charged.

Richardville, R-Monroe, later said there had been a “miscommunication” between him and Casperson, whose vote was among those he had counted on to pass the bill.

“He still had some concerns,” Richardville later said. “I’m the majority leader ... and take the blame.”

The agreement they struck answered complaints Casperson said he’s heard from constituents about cost-shifting from government-sponsored health plans to private-paying patients.

“If you don’t have insurance, you can be billed up to three times what the actual cost is,” he said. “People have got a noose around their neck for the rest of their lives trying to pay off those bills.”

In truth, though, he hadn’t expected to be in the heat of the Medicaid battle Tuesday.

Representing a number of hard-pressed smaller hospitals dependent on Medicaid patients, he had driven to Lansing on Monday planning to raise his remaining concerns with Richardville then quietly cast a vote in favor of the governor’s expansion proposal.

He’s as much an opponent of Obama’s Affordable Car Act as any Republican, he said, but doesn’t believe voting against Medicaid expansion in Michigan would do anything to stop it.

“We have to work with the cards we’ve been dealt,” he said. “I’m not going to watch my hospitals crumble for what in my opinion only would be a political vote.”

That makes him a target of groups such as Americans for Prosperity that carried on an intense lobbying campaign against Medicaid expansion during the summer. They focused on senators who were perceived to be on the bubble, threatening to bankroll GOP primary-election opponents and opposition ad campaigns in 2014.

Casperson, who’s eligible to seek a second term next year and also may have his eye on a run for Congress down the road, will have to face their wrath.

Scott Hagerstrom, state director of Americans for Prosperity-Michigan, charged those voting for Medicaid expansion “are complicit with the Obama administration. We are prepared to dedicate significant resources to educating citizens on how their Senators voted on this issue," he said.

Casperson said he knows his vote is “a bump in the road ... for some people — those who are hard-right.

“(But) I think I’m good to go up here,” he said. “I’ve had a lot of discussions. I think everybody up here pretty much expected I was going to support this.”
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