Lawmakers slow Medicaid expansion in Flint

Chad Livengood
Detroit News Lansing Bureau

Lansing — Two months ago this week, the federal government approved Gov. Rick Snyder’s request to extend Medicaid health insurance to another 14,000 Flint children and 1,000 pregnant women who may have been exposed to toxic lead through the city’s tainted drinking water.

But the health care coverage has yet to be activated because it requires approval of the state Legislature, where the wounds of a divisive 2013 Medicaid expansion battle still linger.

Snyder’s request to give health insurance to thousands of additional Flint residents got wrapped into a $144 million supplemental funding bill for the city. That bill was put on a slower track with the overall $55 billion state budget, which lawmakers plan to pass by June.

“The speed is frustrating. We’re losing that sense of urgency at the state and federal level,” said Dr. Mona Hanna-Attisha, the Hurley Medical Center pediatrician who last year discovered high levels of lead in the blood of Flint children.

Hanna-Attisha urged Snyder administration officials two weeks ago at a meeting of a committee coordinating Flint emergency relief efforts to get the Medicaid program up and running faster.

“We have to work with our Legislature,” said Nick Lyon, director of the Michigan Department of Health and Human Services, which manages the Medicaid program. “That’s the work we’re doing now.”

The plan would expand the income eligibility threshold for Medicaid in Flint from 133 percent to 400 percent of the federal poverty rate, meaning a family of four earning up to $97,200 per year could get coverage. An individual earning up to $47,520 annually could get Medicaid coverage, which is typically available only to low-income families.

Another 29,000 low-income Flint residents already enrolled in Medicaid would get additional case management services under the federal waiver, says the state health department.

Flint Water Crisis

Lead poisoning can cause damage to the brain, nervous system and kidneys and can result in anemia, slower growth and behavioral problems in children. The lingering long-term health effects led Snyder to quickly seek federal approval for adding to Flint’s Medicaid rolls in mid-February.

State Rep. Jeff Irwin, D-Ann Arbor, said the Medicaid expansion should have been approved by lawmakers in March — before they adjourned for a two-week spring break.

“There’s no reason why we couldn’t have done those emergency appropriations on an emergency basis,” said Irwin, of the House Appropriations Committee. “But instead, we’re forcing them to ride with the rest of the budget, which just delays the help the people of Flint need. I’m frustrated by that.”

Federal officials this winter approved expanded Medicaid for Flint residents in less than three weeks.

The slow pace of the annual budget process prompted Republican lawmakers last week to begin separating the Medicaid expansion from the larger Flint funding bill.

The House Appropriations Committee approved a resolution authorizing $4.4 million in state funds for the Medicaid program in Flint, which will draw $20.8 million in federal matching funds.

“We needed to act on the Medicaid piece, so we did,” said Rep. Al Pscholka, a Stevensville Republican and chairman of the committee.

On Wednesday, the Senate Appropriations Committee plans to vote for the same resolution. The procedure allows legislative appropriators to bypass votes in the full House and Senate and speed aid for the temporary Medicaid expansion.

“We got word that the department is further along than they thought and could be ready to enroll people relatively soon,” said Sen. Dave Hildenbrand, a Lowell Republican and chairman of the Senate Appropriations Committee. “They’re ready to roll.”

Once approved, the Medicaid plan will cover such health services as routine doctor visits, vision care, dental, behavioral health and well-child visits, Health and Human Services spokeswoman Jennifer Eisner said.

The health care coverage will be available to any eligible Flint resident who was served by the city’s water system since April 2014 until an unspecified “future date when the water system is deemed safe,” Eisner said.

Senate Minority Leader Jim Ananich, D-Flint, attributes the two-month delay in expanding the program for his constituents to the 2013 expansion of Medicaid to 615,000 low-income adults.

The contentious battle between Snyder and fellow Republicans entailed accepting billions of dollars in new federal aid through President Barack Obama’s health care law. It also put the state on the hook for increasing state spending on the government health coverage when the feds cut their subsidy next year from 100 percent to 95 percent and eventually to 90 percent in 2020.

“I thought from the beginning it was a good way to make sure we take advantage of every federal dollar we can get,” Ananich said. “... It seemed like a pretty easy one to me. But I think there was some confusion about whether or not it had something to do with Obamacare and clearly it doesn’t.”

“I definitely know it’s needed,” Ananich added.