Medicaid melee as 37th District candidates defend expansion votes

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State Senate 37th District GOP primary

Medicaid expansion is a key point of contention in the Republican primary race between former TV weatherman and state Rep. Greg MacMaster and state Rep. Wayne Schmidt, in a state Senate district that includes the northwestern part of the Lower Peninsula and the eastern portion of the Upper Peninsula. As MacMaster states, he switched his vote to a “no” on Medicaid expansion while Schmidt twice voted for the measure signed into law last September.


Who:Greg MacMaster for state SenateWhat:Candidate statements on Medicaid expansionThe Call:Regular Foul

Relevant text:

“When the expansion was first voted on in the House, I supported it. This wasn’t really Obamacare, we were told. This was Michigan getting its fair share back from Washington...As more facts came to light, my opinion of the bill changed. And, in September, I changed my vote and voted against Obamacare’s Medicaid expansion. I was the only House member to change their vote. I’m proud that I did.

“My heart goes out to those that were laid off or forced to seek employment elsewhere due to the passage of the Medicaid expansion. While I voted 'NO' for it - I'm working diligently to repeal this colossal mistake and disassociate it with the ACA.”

Before this year, Medicaid in Michigan was largely limited to children, parents below the poverty level with dependent children, the elderly and disabled.

Expansion widens that to include the uninsured “working poor,” individuals or families making up to 138 percent of the federal poverty level. More than 320,000 had signed up in Michigan by early July since enrollment began on April 1. That is expected to approach 500,000 within a few years. Under terms of the Affordable Care Act, the federal government is committed to pay the full cost of Medicaid expansion through 2016. Its share would fall to 90 percent by 2020 with states to pay no more than 10 percent after that. Gov. Rick Snyder calculates general fund savings of more than $200 million a year and plans to bank half of that to defray future costs.

A 2013 analysis by the state Senate Fiscal Agency projects that the “crossover point” –where costs exceed savings – could occur anywhere from 2023 to 2036.

MacMaster's statement that he was told Medicaid expansion “wasn't really Obamacare” doesn't square with the facts or the way Obamacare was presented. Medicaid expansion was always a key component of the Affordable Care Act, approved by the U.S. Supreme in June 2012 but with the option for states to opt out of Medicaid expansion that was part of the act. Asked to elaborate on his change of position, MacMaster said he learned after his vote that it could have a “negative effect” on northern Michigan hospitals.

But his assertion that Medicaid expansion cost jobs is not substantiated. A MacMaster campaign spokesperson cited reports of layoffs at hospitals around northern Michigan, including at Mercy Hospital Grayling, which announced in March it is eliminating 24 positions and not replacing 11 other vacant positions.

Hospital CEO Stephanie Riemer-Matuzak said the layoffs were due to a decline in the number of patients receiving services at the hospital. There was also a drop in emergency room visits and outpatient services such as diagnostic testing. But those layoffs were announced before the April 1 enrollment in Medicaid expansion had even begun. McLaren Northern Michigan hospital in Petoskey announced in February it is eliminating 40 jobs, but those layoffs were also announced well in advance of Medicaid expansion enrollment.

The call:Regular Foul

MacMaster’s assertion that Medicaid expansion in Michigan is costing jobs is not substantiated.

Who:Rep. Wayne Schmidt
What:Statements on Medicaid expansion issued in September 2013
The call:No Foul

Relevant text:

“We have worked hard in both the House and Senate to craft a program that emphasizes personal responsibility while saving taxpayer money. This will benefit people in Northern Michigan, some of whom currently use expensive emergency room care as their primary source of health care which drives up the cost of healthcare for us all...We are taking every step to ensure that taxpayers are protected and that our most vulnerable families have access to the health care they need.”

Schmidt issued these statements through the Michigan House Republicans about the time of passage of Medicaid expansion. As he noted, those making between 100 percent and 138 percent of the federal poverty level are to contribute up to 2 percent of their income to a health savings account that can be used to pay out-of-pocket expenses.

The plan offers incentives for healthy behavior such as smoking cessation and weight loss. Though the cost of Medicaid expansion is to be paid 100 percent by the federal government through 2016, it is difficult to know with certainty what its cost to the state might be a decade later. Its impact on hospitals long-term is still unknown.

In fiscal 2011, Michigan hospitals had more than $882 million in charity and uncompensated care. Research and interest groups continue to disagree over the impact of Medicaid expansion. Health Affairs, a nonprofit research organization, predicted improved health care outcomes and reduced cost of catastrophic care. The conservative Heritage Foundation warned that Medicaid expansion is part of “unsustainable” growth in entitlement spending. It also warns there is no guarantee federal funding will continue as promised.

The call:No Foul

Schmidt is correct in stating that Michigan's expanded Medicaid asks for personal accountability. For now, its cost is paid by the federal government. Its cost to Michigan a decade or more from now is uncertain.

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Tue, 07/29/2014 - 7:35am
It’s a shame that Bridge Magazine is unfairly reporting this story. Obamacare (Affordable Care Act) does cost jobs and you can find many resources that defend this fact. Job losses include the following: companies in the medical equipment industry, e.g. Abbot Labs in NYS, has already cut jobs because of new fees and costs due to the Affordable Care Act; many companies with 30 – 90 employees have had to reduce hours to part time or eliminate jobs, reduce job growth or outsource work because of their being forced to pay for Obamacare for full-time employees; I believe the Cleveland Clinic has cut jobs in order to prepare for Obamacare costs. There are additional cuts to home health care services for seniors and cuts in allowable medications. Investor’s Business Daily reports many Michigan schools and public institutions have had to reduce job hours to less than 30 in order to avoid paying high insurance fees they can’t afford. So when Bridge reports there are no job loses, or cuts, I’m not sure what you’re talking about.
Tue, 07/29/2014 - 6:01pm
Not one objective study has shown that the Affordable Care Act will cost our economy jobs in the end. What studies have proven is that people will be able to take entrepreneurial risks they couldn't take before or otherwise will be able to opt out of the job market temporarily or permanently because health care becomes significantly more affordable. Your claim about "30-90 employees" (quite a wide range) is purely anecdotal. Anyone with two active brain cells understands that anything can be proven based on anecdotal evidence. You cite the Cleveland Clinic, which did reduce their budget for this year due to their speculation on the effects of the Affordable Care Act. Once again, pulling one "fact" out of the middle of the air proves nothing without knowing what's happening more generally among major health care providers, what the trend has been, the actual impact of ACA, etc.
Big D in 37th
Tue, 07/29/2014 - 10:33am
To me the key difference between these candidates is who is being supported by mudslinging PACs in Lansing. Since they like Schmidt, there must be something about his record and/or promises that they like, and that is bad. Their lack of integrity and their meanness has turned me off to Wayne. ...and I certainly don't want to vote for someone who appears to appeal to the cronies. It puzzles me why Bridge doesn't look at that aspect of the race.
Joey K
Tue, 07/29/2014 - 11:33am
As opposed to mudslinging super-PACs from D.C.? MacMaster has kowtowed to the special interests of a few people from outside the state at the expense and to the detriment of northern Michigan. At least what was put out about Greg is true (and frankly, a candidate that claims to be a family man and fiscally conservative should be called out for not paying taxes and walking out on multiple families).
Tue, 07/29/2014 - 1:45pm
When a candidate has to sling mug you know he/she can't talk about their record and are desperate to get elected. If they will prostitute a family member then they will definitely prostitute a voter. Beware.
Mark Eckhoff
Tue, 07/29/2014 - 10:42am
This debate over the Medicaid expansion is nothing more than pandering to all of us (myself included) that do not like the ACA. Unfortunately, the ACA (Obamacare) is the law but that is no reason to not expand the Medicaid coverage for lower income people. To not take the money that Michigan taxpayers originally paid the Federal government is cutting off your nose to spite your face. This is an example of taking an unpopular law (ACA) and spinning it to try and make it appear that your opponent supports it. Schmidt does not support Obamacare.
Wed, 07/30/2014 - 12:31pm
State acceptance of Medicaid Expansion is the state and federal handshake on giving up fighting Obamacare. It is the state saying yes master we'll do your bidding, so go ahead and send us the money, . (accepting bribery- of our own money no less). Representatives are to cowardly to say - "Stop taxing us to give our own money back." Cutting off your head to not spite your pocket book is more appropriate.
Phil Bellfy
Sun, 08/03/2014 - 9:58am
I'm one of two Democratic Party challengers hoping to move on to the November election to face either of the two "Tea Party" Republican candidates (Schmidt or Macmaster) in the 37th State Senate district. Both of these sitting House members voted to reduce environmental protections, voted to slash school funding, voted to tax pensions, and voted to declare war on the middle-class and women. Neither one is deserving of support form any sector of the electorate, right or left. When we talk about the "lesser of two evils" in politics, we're talking about these two "evils." Vote Democratic and vote for something positive for a change (and vote for me in the Primary).